- Current Issue
Pre-operatif sildenafil dan perannya pada hipertensi pulmonal terkait dengan penyakit katup jantung kiri: Laporan Kasus dan telaah pustaka
I Gusti Bagus Aginda Dwipawana, IGN Putra Gunadhi, Hendy Wirawan, Rani Maliawan, Ketut Putu YasaOnline First: Mar 7, 2023
- Abstract
Pre-operatif sildenafil dan perannya pada hipertensi pulmonal terkait dengan penyakit katup jantung kiri: Laporan Kasus dan telaah pustaka
Introduction: Pulmonary hypertension (PH) is a pathological disorder of the pulmonary vessels that results in various clinical manifestations and causes cardiovascular and respiratory complications. This case report will discuss patients with heart failure due to rheumatic heart disease with severe mitral stenosis, moderate aortic stenosis, moderate-severe aortic regurgitation, severe tricuspid stenosis and the role of sildenafil in the preoperative period in patients with left heart valve disease with PH.
Case Description: A 40-year-old man came to the polyclinic complaining of fatigue and shortness of breath 6 months ago. From a regular S1 S2 heart examination, there was a murmur, and no signs of congestion were found in the patient. Electrocardiography showed 94 beats per minute sinus rhythm with poor R wave progression. On echocardiography found, patients with severe mitral stenosis, moderate aortic stenosis and regurgitation, and severe tricuspid regurgitation, with decreased LV systolic function and RV systolic function. The patient was planned for DVR + TV repair by a Cardiothoracic Surgeon. During the 24 hours preoperatively, the patient was given sildenafil 20 mg every 8 hours, which was continued for 72 hours postoperatively. The patient started mobilization on the third postoperative day, and there were no significant complications during the hospitalization. The patient was discharged on the 10th postoperative day with a total stay of 12 days.
Discussion: In patients with PH associated with left heart disease, the main strategy for repairing HP is to treat the underlying left heart condition. This also applies to significant left valve disease. One of the PH therapy options related to heart valve disease is sildenafil. Sildenafil relaxes pulmonary vascular smooth muscle and reduces pulmonary arterial pressure in various types of PH. Studies have shown that preoperative use of sildenafil significantly affects patients with PH associated with valvular heart disease. The administration of sildenafil is also effective for use postoperatively to reduce the need for postoperative inotropic support and reduce postoperative ventilation time.
Conclusion: One of the PH therapy options related to heart valve disease is sildenafil because of its effectiveness and relatively safe use before and after surgery.
Pendahuluan: Hipertensi Pulmonal (HP) merupakan kelainan patologis pada pembuluh darah paru yang mengakibatkan berbagai manifestasi klinis dan menimbulkan komplikasi kardiovaskular maupun respirasi. Pada laporan kasus akan dibahas pasien yang mengalami gagal jantung karena penyakit jantung rematik dengan stenosis mitral berat, stenosis aorta sedang, regurgitasi aorta sedang-berat, stenosis trikuspid berat serta peranan sildenafil pada masa pre-operatif pasien penyakit katup jantung kiri dengan HP.
Deskripsi Kasus: Laki-laki usia 40 tahun, datang ke poliklinik jantung dengan keluhan cepat lelah dan mudah sesak sejak 6 bulan yang lalu. Dari pemeriksaan jantung S1 S2 reguler didapatkan adanya murmur dan tidak ditemukan tanda kongesti pada pasien Elektrokardiografi menunjukkan irama sinus 94 kali per menit dengan poor R wave progression. Pada ekokardiografi didapatkan pasien dengan stenosis mitral berat, stenosis dan regurgitasi aorta sedang, regurgitasi trikuspid berat, dengan fungsi sistolik LV dan fungsi sistolik RV yang menurun. Pasien direncanakan untuk tindakan double valve replacement dan tricuspid valve repair oleh sejawat Bedah Thoraks Kardiovaskular. Saat 24 jam pre operasi, pasien diberikan sildenafil 20 mg tiap 8 jam yang diteruskan hingga 72 jam pasca operasi. Pasien memulai mobilisasi pada hari ketiga pasca operasi dan tidak ada komplikasi signifikan yang dialami pasien selama rawat inap. Pasien dipulangkan pada hari ke 10 pasca operasi dengan total lama rawat 12 hari.
Diskusi: Salah satu opsi terapi HP terkait dengan penyakit katup jantung adalah sildenafil. Sildenafil merelaksasi otot polos pembuluh darah pulmonal dan menurunkan tekanan arteri paru pada berbagai jenis HP. Penelitian-penelitian menunjukkan penggunaan sildenafil sebelum operasi memiliki efek yang signifikan pada pada pasien dengan HP yang terkait dengan penyakit katup jantung. Pemberian sildenafil juga efektif digunakan pasca operasi sehingga dapat mengurangi kebutuhan akan dukungan inotropik pasca operasi dan mengurangi waktu ventilasi pasca operasi.
Simpulan: Sildenafil merupakan salah satu opsi terapi HP terkait dengan penyakit katup jantung dikarenakan efektivitasnya dan penggunaanya relatif aman untuk digunakan baik sebelum tindakan operasi maupun setelah tindakan operasi.
Latissimus dorsi flap after mastectomy surgery: case series
Cecillia Young, Sweety Pribadi, Bernard Agung BaskoroOnline First: Jan 25, 2023
- Abstract
Latissimus dorsi flap after mastectomy surgery: case series
Background: Breast cancer is the most common type of cancer in women. Breast cancer can be treated with mastectomy surgery, chemotherapy, hormonal, radiation, and biological agent therapy. Surgery is the primary therapy for breast cancer. The most common surgical procedure is a mastectomy which can be continued with breast reconstruction after mastectomy surgery to improve the shape and close the breast defects. Breast reconstructions can be performed with breast implant surgery and autologous or “flap” reconstruction. Latissimus Dorsi (LD) flap is a pedicled flap often used for breast reconstruction. Mastectomy surgery and breast reconstruction complications are seromas, late hypertrophic scars, hematomas, pain, muscle weakness, and infections. This study aimed to describe the case series of latissimus dorsi flaps in breast cancer patients after mastectomy surgery.
Case presentation: The author presents 6 cases of breast cancer patients after mastectomy surgery performed breast reconstruction using an LD flap. Five patients had a history of surgery on the abdomen, and one did not have a history of abdominal surgery but had planned pregnancy in the future. There were no complications after LD flap reconstruction surgery. LD flap surgery may be accompanied by implants so that the shape and size can be close to another breast, but related to the cost, and the patients refuse to use a breast implant. All patients were given chemotherapy before surgery.
Conclusion: Breast reconstructive surgery is used to close defects after mastectomy surgery and can improve the quality of life of breast cancer patients. Pedicled LD flaps are one of the techniques often used for breast reconstruction cases because of rare complications of necrosis in the donor area or flaps.
Management of thyroid crisis in a patient with febrile neutropenia
Wira Gotera, Stephanie Sugiharto, Ida Bagus Aditya NugrahaOnline First: Feb 7, 2023
- Abstract
Management of thyroid crisis in a patient with febrile neutropenia
Introduction: Thyroid storm is a life-threatening complication of acute hyperthyroidism. The diagnosis of thyroid storm can only be based on its clinical manifestations, which include decreased consciousness, high fever, heart failure, diarrhea and jaundice. Antithyroid drug therapy (ATD) is one option for treating hyperthyroidism, along with surgery and radioactive iodine. ATD is thought to cause neutropenia through the agranulocytosis pathway. The most common symptoms are fever and sore throat accompanied by symptoms of a thyroid crisis. There is no specific method for predicting the appearance of febrile neutropenia caused by ATD. Routine complete blood counts in patients taking ATD should be performed. The diagnosis of febrile neutropenia due to ATD needs to be done immediately so that timely intervention can be carried out and reduce mortality.
Case Presentation: a 25 years old female with thyroid crisis and febrile neutropenia. Clinical findings in the patient include fever, decreased consciousness, palpitation, excessive sweat, diarrhea, nausea and vomiting, weight loss, and the laboratory findings of leukopenia and neutropenia of (leucocyte 1.03x103/uL, neutrophil 1.90x103/ul). Ultrasonography examination of the thyroid reveals a thyroiditis image with multiple solid nodules. Blood smear examination reveals leukopenia with differential count examination of blood showed neutropenia, moderate lymphocytosis, erythrocyte hypochromic micrositer, poikilocytosis ovalocyte, teardrop cell, fragmentosist and target cell. Polychromasia and normoblast cells are not found.
Conclusion: Thyroid crisis refers to the clinical findings and thyroid hormone test results. There is no specific method to predict the appearance of febrile neutropenia caused by the antithyroid drug. Frequent blood tests must be done in patients who consume antithyroid drugs.
Kondiloma lata perianal yang awalnya diduga bowenoid papulosis disertai balanitis candida pada remaja laki-laki
Joice Gunawan Putri, Ni Made Dwi Puspawati, Herman SaputraOnline First: Jan 19, 2023
- Abstract
Kondiloma lata perianal yang awalnya diduga bowenoid papulosis disertai balanitis candida pada remaja laki-laki
Background: Condyloma lata is a form of secondary syphilis that manifest in moist, flat, firm boundaries papules or plaques with macerated surface that resembles the appearance of bowenoid papulosis. Differentiating this disease requires supporting examinations so that appropriate treatment can be determined. This case report discusses a case of condyloma lata, which was originally suspected to be bowenoid papulosis and accompanied by balanitis candida.
Case: A 14 years teenage boy, complained of warts near the anus and white spots on the gland penis since 1 month ago. Dermatovenereology examination on the perianal region showed a hyperpigmented solitary plaque, well-defined margin, geographic shape, flat surface and a solitary ulcer at the edges. On the glans penis, multiple white plaques, well defined, geographic shape, moist surface. Acetowhite examination was negative and a dark field microscope (DFM) examination of perianal lesions found Treponema pallidum. The potassium hydroxide examination on the glans penis found pseudohyphae and blastospores. Gram examination was found normal. The VDRL serology examination was reactive (1:64), and the TPHA was found to be reactive. The patient was diagnosed with condyloma lata coinfection with balanitis candida. Treatment involves a single intramuscular injection of benzathine penicillin 2.4 million IU and fluconazole 150 mg capsules intraorally single dose. Observations within 1 month showed clinical improvement in condyloma lata and balanitis.
Conclusion: This case provides an understanding of condyloma lata's clinical course, which mimics other diseases in an immunocompetent patient. Treatment based on etiology provides a good clinical improvement in patients.
Latar belakang: Kondiloma lata merupakan suatu bentuk sifilis sekunder yang dapat bermanifestasi berupa papul maupun plak yang lembab, datar, berbatas tegas dengan permukaan maserasi. Bowenoid papulosis adalah penyakit yang menyerupai gambaran kondiloma lata. Membedakan penyakit ini diperlukan pemeriksaan penunjang sehingga dapat menentukan pengobatan yang sesuai. Laporan kasus ini membahas kasus kondiloma lata yang semula diduga bowenoid papulosis dan disertai balanitis candida pada remaja laki-laki.
Kasus: Seorang remaja laki-laki, usia 14 tahun, mengeluhkan adanya kutil di dekat dubur dan bercak putih pada kelamin sejak 1 bulan yang lalu. Status dermatovenereologi pada regio perianal didapatkan plak soliter hiperpigmentasi, batas tegas, bentuk geografika, permukaan rata dan di tepinya terdapat ulkus soliter. Pada glans penis didapatkan plak putih multipel, berbatas tegas, bentuk geografika, permukaan lembab. Pemeriksaan acetowhite didapatkan negatif, pemeriksaan dark field microscope (DFM) pada lesi perianal didapatkan Treponema pallidum. Pemeriksaan kalium hidroksida (KOH) pada glans penis didapatkan adanya pseudohifa dan blastospora. Pemeriksaan gram pada glans penis tidak ditemukan adanya leukosit, kokus gram positif maupun batang gram negatif. Pemeriksaaan serologi Venereal Disease Research Laboratory (VDRL) reaktif 1:64 dan Treponema Pallidum Haemagglutination Assay (TPHA) didapatkan reaktif. Pasien didiagnosis kondiloma lata disertai balanitis candida. Penatalaksanaan dengan injeksi benzatin penisilin 2,4 juta IU intramuskular dosis tunggal dan flukonazol kapsul 150 mg intraoral dosis tunggal. Pengamatan dalam 1 bulan didapatkan perbaikan klinis pada kondiloma lata dan balanitis.
Simpulan: Kasus ini memberikan pemahaman mengenai klinis kondiloma lata yang menyerupai dengan penyakit lain dan disertai koinfeksi candida pada pasien imunokompeten. Penanganan berdasarkan etiologi memberikan perbaikan klinis yang baik pada pasien.
Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus
Kadek Enny Pradnyaswari, Anak Agung Ratna Purnama Santhi, Romy WindiyantoOnline First: Mar 3, 2023
- Abstract
Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus
Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can attack various organ systems with varying severity, ranging from mild to life-threatening. Multisystem inflammatory syndrome (MIS-C) is a hyper-inflammatory state characterized by multiorgan dysfunction caused by secondary inflammation to previous SARS-CoV-2 infection. SLE and MIS-C have similar symptoms because both diseases attack various organ systems. This paper aims to provide an overview of pediatric patients who are enforced with two diagnoses, namely SLE and MIS-C.
Case presentation: A 10-year-old female patient came to the emergency room at Sanjiwani Regional General Hospital, Gianyar, with the chief complaint of fever for four days before entering the hospital. Complaints accompanied by swollen eyelids, cough, nausea, abdominal pain, diarrhea, and lymphadenopathy. Clinical manifestations were found in various organ systems based on anamnesis, physical examinations, and laboratory examinations. The patient was diagnosed with SLE based on the EULAR/ACR 2019 criteria (obtained a score of 13) and MIS-C based on the MIS-C case definition criteria according to WHO.
Conclusion: The diagnosis of SLE is established based on EULAR/ACR 2019 criteria (obtained a score of 13), and the diagnosis of MIS-C is selected based on the MIS-C case definition criteria according to WHO.
Latar belakang: Lupus eritematosus sistemik (LES) adalah penyakit autoimun kronis yang mampu menyerang berbagai sistem organ dengan tingkat keparahan penyakit yang beragam, mulai dari ringan hingga mengancam nyawa. Multisystem inflammatory syndrome (MIS-C) adalah suatu keadaan hiperinflamasi yang ditandai dengan disfungsi multiorgan yang disebabkan oleh peradangan sekunder akibat infeksi SARS-CoV-2 sebelumnya. LES dan MIS-C memiliki kemiripan gejala karena sama-sama menyerang berbagai sistem organ. Tujuan penulisan ini adalah untuk memberikan gambaran kasus pasien anak yang ditegakkan dengan dua diagnosis yaitu LES dan MIS-C.
Presentasi kasus: Seorang pasien perempuan, berusia 10 tahun datang ke IGD RSUD Sanjiwani, Gianyar dengan keluhan utama demam sejak 4 hari sebelum masuk rumah sakit. Keluhan disertai kedua kelopak mata bengkak, batuk, mual, nyeri perut, diare, dan limfadenopati. Berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang didapatkan adanya manifestasi klinis pada berbagai sistem organ. Pasien didiagnosis dengan LES berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan MIS-C berdasarkan kriteria definisi kasus MIS-C menurut WHO.
Simpulan: Diagnosis LES ditegakkan berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan diagnosis MIS-C ditegakkan berdasarkan kriteria definisi kasus MIS-C menurut WHO.
Laporan kasus: kanker caput pankreas pada pasien dengan infeksi hepatitis B kronis
Ni Kadek Seri Mahayanti, I Putu Alit SudarsanaOnline First: Feb 16, 2023
- Abstract
Laporan kasus: kanker caput pankreas pada pasien dengan infeksi hepatitis B kronis
Background: Pancreatic cancer is the seventh leading cause of cancer death globally according to the 2020 Global Cancer Statistics. Pancreatic cancer does not show clear clinical signs in its early stages and it is usually diagnosed in the advanced phase with poor response to treatment. The risk is increased in smokers, black race, high-fat diet, alcohol, the elderly, the presence of infection, diabetes mellitus, and chronic pancreatitis.
Case report: We report a 72-year-old female patient with complaints of abdominal enlargement and jaundice. Patients also with complain of light colored stools and dark urine. Physical examination revealed tenderness on palpation of the right upper quadrant of the abdomen accompanied by an enlarged liver. Laboratory examination revealed anemia accompanied by an increase in total bilirubin with predominance in direct bilirubin. HbsAg examination showed positive results. Ultrasound examination showed a mass in the head of the pancreas with dilatation of the common bile duct to the intrahepatic bile duct and there was a hydrops gallbladder. Abdominal CT scan showed a well-defined contrast-enhanced mass measuring 36 cm x 4.4 cm x 6 cm in the head area.
Conclusion: Pancreatic head cancer is a rare type of cancer, but has a high malignancy. Establishing the correct diagnosis is generally difficult. This is because symptoms generally appear after the cancer has reached an advanced stage.
Latar Belakang: Kanker pankreas menjadi penyebab kematian ketujuh terbanyak akibat kanker secara global menurut Global Cancer Statistics tahun 2020. Kanker pankreas tidak menunjukkan tanda-tanda klinis yang jelas pada fase awal dan biasanya didiagnosis pada fase lanjut dengan respon yang buruk terhadap pengobatan. Risiko meningkat pada perokok, ras kulit hitam, diet tinggi lemak, alkohol, lansia, adanya infeksi, diabetes mellitus, dan pankreatitis kronis.
Laporan kasus: Kami melaporkan seorang pasien wanita berusia 72 tahun dengan keluhan keluhan pembesaran abdomen dan jaundice. Pasien juga dengan keluhan feses berwarna terang dan urin gelap. Ditemukan nyeri tekan pada palpasi kuadran kanan atas abdomen disertai pembesaran hati. Pemeriksaan laboratorium didapatkan anemia disertai peningkatan pada bilirubin toal dengan dominan pada bilirubin direk. Pemeriksaan HbsAg menunjukkan hasil positif. Pemeriksaan ultrasonograafi menunjukkan adanya massa pada caput pancreas dengan dilatasi common bile duct hinga intrahepatic bile duct dan terdapat hydrops gall bladder. Pemeriksaan CT scan abdomen menunjukkan massa menyangat kontras berbatas tegas ukuran 36 cm x 4,4 cm x 6 cm di daerah caput.
Kesimpulan: Kanker caput pancreas merupakan jenis kanker yang tergolong jarang, namun memiliki keganasan yang tinggi. Penegakan diagnosis yang tepat pada umumnya mengalami kesulitan. Hal ini disebabkan karena gejala pada umumnya muncul setelah kanker telah mencapai stadium lanjut.
Seorang laki-laki dewasa muda dengan multiple myeloma monoklonal gamopati lambda: sebuah laporan kasus
Cahyo Edi Baskoro, Ni Made Renny Anggreni RenaOnline First: Feb 23, 2023
- Abstract
Seorang laki-laki dewasa muda dengan multiple myeloma monoklonal gamopati lambda: sebuah laporan kasus
Introduction: Multiple myeloma is the second most common hematological malignancy after non-Hodgkin's lymphoma with a case prevalence in Prof. Dr. I.G.N.G. Ngoerah Hospital for the 2013-2017 period was 4.64% with the most cases occurring in 2017 (33.3%), where 45.8% of multiple myeloma patients were in the age group of 51-60 years old. This study aims to describe a case of multiple myeloma monoclonal gammopathy lambda in a young adult male which is a very rare case.
Case Presentation: 35-year-old male patient whose laboratory and radiological findings supported a diagnosis of multiple myeloma, the right clavicle pain was the primary complaint, and radiological imaging revealed brittle bones. Furthermore, the examination of bone marrow aspiration smear, serum protein electrophoresis, routine hematology, erythrocyte sedimentation rate, clinical chemistry (such as calcium, uric acid, liver function tests, urea and creatinine), and radiological examination, such as the plain X-ray of bone) shows prominent and specific laboratory findings to confirm multiple myeloma.
Conclusion: The diagnosis of multiple myeloma was established with manifestations of bone lesions, serum protein electrophoresis and bone marrow biopsy were carried out for diagnosis based on the International Myeloma Working Group (IMWG) diagnostic criteria. Monitoring after administering six series of primary management of multiple myeloma in patient showed significant improvement from the results of laboratory evaluation, radiology, and bone marrow imaging.
Latar Belakang: Multiple myeloma adalah keganasan hematologis kedua yang paling umum setelah limfoma non-Hodgkin dengan prevalensi kasus di RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2013-2017 adalah 4,64% dengan kasus terbanyak terjadi pada tahun 2017 (33,3%), dimana 45,8% pasien multiple myeloma berada pada kelompok umur 51-60 tahun. Studi ini bertujuan ini untuk mendeskripsikan kasus multiple myeloma monoklonal gamopati lambda pada seorang laki-laki dewasa muda yang merupakan kasus sangat jarang.
Presentasi Kasus: Pasien laki-laki berusia 35 tahun dengan hasil laboratorium dan radiologis mendukung diagnosis multiple myeloma, nyeri klavikula kanan adalah keluhan utama, dan pemeriksaan radiologi menunjukkan tulang rapuh. Selanjutnya pemeriksaan apusan aspirasi sumsum tulang, elektroforesis protein serum, hematologi rutin, laju endap darah, kimia klinik (seperti kalsium, asam urat, tes fungsi hati, ureum, dan kreatinin), dan pemeriksaan radiologis, seperti foto polos X- ray tulang) menunjukkan temuan laboratorium yang menonjol dan spesifik untuk mengkonfirmasi multiple myeloma.
Simpulan: Diagnosis multiple myeloma ditegakkan dengan manifestasi lesi tulang, telah dilakukan pemeriksaan elektroforesis protein serum dan biopsi sumsum tulang untuk penegakan diagnosis berdasarkan kriteria diagnostik International Myeloma Working Group (IMWG). Monitoring setelah pemberian enam seri tatalaksana primer multiple myeloma pada pasien didapatkan perbaikan yang signifikan dari hasil evaluasi laboratorium, radiologis, dan gambaran sumsum tulang.
Low serum irisin levels in newly diagnosed patients with type 2 diabetes mellitus: a meta-analysis
I Gusti Ngurah Metta Nurcahya, Ayu Agung Pradnya Paramitha, Ida Bagus Indra Wibawa Putrawan, Dewi Catur WulandariOnline First: Mar 1, 2023
- Abstract
Low serum irisin levels in newly diagnosed patients with type 2 diabetes mellitus: a meta-analysis
Background: Low irisin levels, a marker widely reported to be associated with developing insulin resistance and type 2 diabetes mellitus. This study aims to provide evidence regarding irisin levels in patients newly diagnosed with type 2 diabetes mellitus.
Methods: A systematic review and meta-analysis of observational studies in adults over 18 newly diagnosed with type 2 diabetes mellitus. The databases used for this study were PubMed, ProQuest and ScienceDirect. Only English studies were considered in the database searched from the beginning to October 2022. The data obtained were analyzed using the RevMan 5.4 application.
Results: Twelve studies met the inclusion criteria. These were identified using a total of 1,621 patients with; 880 cases and 741 controls. This main point shows that the serum irisin level in patients newly diagnosed with type 2 diabetes mellitus has a mean difference of -7.72 with 95% CI -9.49 to -5.95. Since the evidence collected in our meta-analysis showed heterogeneity (I2 = 99%), a random effects model was performed. The z-test results for the overall effect were statistically significant (P≤0.001).
Conclusion: Irisin levels were significantly lower in patients newly diagnosed with type 2 diabetes mellitus than in the healthy group.
Hubungan antara durasi tidur dengan kejadian obesitas pada anak: sebuah tinjauan sistematis
Peter Prayogo Hsieh, Florencia Christina Sindhu, Made Ratna Dewi, I Gusti Lanang SidhiartaOnline First: Mar 13, 2023
- Abstract
Hubungan antara durasi tidur dengan kejadian obesitas pada anak: sebuah tinjauan sistematis
Background: Obesity in children is a serious health problem with a rapidly increasing global prevalence. Children with obesity are at high risk of developing several metabolic diseases as adults. Studies show that short sleep duration is a risk factor for obesity. Short sleep duration will affect the diurnal rhythm and disrupt homeostasis and energy metabolism. This systematic review aims to determine the relationship between sleep duration and obesity in children.
Methods: A systematic literature review was carried out by literature searching on PubMed and Google Scholar using the PRISMA diagram and based on the eligibility criteria in selecting literature. The study was limited to the last five years (2017-2021). Studies that met the criteria were included in the analysis.
Results: There were 17 studies included in the analysis with cross sectional studies, prospective cohorts and clinical trials study designs regarding the relationship between sleep duration and obesity in children. All studies show a strong association between sleep duration and obesity in children and adolescents. The underlying mechanism is short sleep duration affects the balance of hormones controlling hunger and appetite so that appetite increases and causes excess energy intake, resulting in obesity. Children with short sleep duration are 2-4 times more prone to obesity compared to children with normal sleep duration.
Conclusion: There is a significant relationship between sleep duration and obesity in children and adolescents. Adequate sleep duration is recommended to prevent obesity and the risk of metabolic and cardiovascular diseases.
Comparison of mortality and severity in Coronavirus disease 2019 (COVID-19) patient with and without diabetes mellitus: a systematic review
Christian PoerniawanOnline First: Jan 7, 2023
- Abstract
Comparison of mortality and severity in Coronavirus disease 2019 (COVID-19) patient with and without diabetes mellitus: a systematic review
Background. Coronavirus disease-19 (COVID-19) has been a global pandemic since it was first discovered in Wuhan, China, on December 2019. Several studies found that comorbidity in COVID-19 patients, such as diabetes mellitus is a risk factor for mortality and more severe infection in COVID-19 patients. This systematic review aims to review the comparison of mortality and severity in COVID-19 patients with and without DM.
Method. This systematic review was performed in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) diagram Google Scholar, PubMed, and Europe PMC as electronic database sources. We used a checklist from Joanna Briggs Institute for cross sectional, cohort, and case-control studies for quality assessment.
Result. We included 24 studies in this systematic review, consisting of 19 cohort studies, three cross sectional studies, and two case-control studies. All studies included were classified as good studies by study quality assessment. Most study samples are male patients with an average age of more than 50. All studies found a higher mortality rate and severe infection in COVID-19 patients in the DM group compared with the non-DM group. COVID-19 patients in the DM group have a 7.67 higher mortality risk compared with the non-DM group. While for the severity, COVID-19 patients in the DM group have a 6.07 greater risk for severe infection than the non-DM group.
Conclusion. There is a higher mortality rate and more severe infection in COVID-19 patients in the DM group compared with the non-DM group.
Hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal di kota Banda Aceh, Indonesia
Safrizal Rahman, Alya Kurnila Ramazani, Darma Satria, Azharuddin, Liza SalawatiOnline First: Jan 16, 2023
- Abstract
Hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal di kota Banda Aceh, Indonesia
Introduction: The prevalence of musculoskeletal trauma in Indonesia is increasing. Complications that occur due to mishandling are often found in health facilities. The development of medical health facilities has not made people switch from traditional medicine as an alternative treatment for musculoskeletal trauma that has been passed down for generations. Education and attitude can be factors in considering risks in choosing the right treatment. The purpose of this study was to determine the relationship between education level and attitude towards musculoskeletal trauma treatment options.
Method: This research method is an observational analytic with a cross-sectional design. The research subjects were residents of Banda Aceh City was as many as 200 respondents who were carried out in eleven public health centers representing nine sub-districts in Banda Aceh City.
Result: The results of this study indicate that 108 (54.0%) respondents chose traditional medicine while 92 (46.0%) other respondents chose medical treatment as a solution for treating musculoskeletal trauma. Respondents with secondary education chose traditional medicine by 62.7%, while respondents with higher education chose traditional medicine by 42.9%. Respondents with a sufficient attitude chose traditional medicine by 95.6%, while respondents with a good attitude chose traditional medicine by 31.4%. Based on the results of the Spearman rho test, it showed that there was a relationship between educational level (p=0.039) and attitude (p=0.000) towards the choice of musculoskeletal trauma treatment.
Conclusion: Various promotive efforts and health education, especially musculoskeletal trauma, need to be continuously carried out by both health workers and policy makers to improve people's attitudes in choosing the right treatment and reducing the number of complications due to mishandling of musculoskeletal trauma in Banda Aceh City.
Pendahuluan: Prevalensi trauma muskuloskeletal di Indonesia semakin meningkat. Komplikasi yang terjadi akibat kesalahan penanganan banyak ditemukan di fasilitas kesehatan. Berkembangnya fasilitas kesehatan medis tidak membuat masyarakat beralih dari pengobatan tradisional sebagai alternatif pengobatan trauma muskuloskeletal yang sudah turun temurun. Pendidikan dan sikap dapat menjadi faktor dalam mempertimbangkan risiko dalam memilih pengobatan yang tepat. Tujuan dari penelitian ini adalah untuk mengetahui hubungan tingkat pendidikan dan sikap terhadap pilihan pengobatan trauma muskuloskeletal.
Metode: Metode penelitian ini berupa analitik observasional dengan desain cross-sectional. Subjek penelitian adalah penduduk Kota Banda Aceh sebanyak 200 responden yang dilaksanakan pada sebelas puskesmas yang mewakili sembilan kecamatan di Kota Banda Aceh.
Hasil: Hasil penelitian ini menunjukkan bahwa 108 (54,0%) responden memilih pengobatan tradisional sedangkan 92 (46,0%) responden lainnya memilih pengobatan medis sebagai solusi untuk penanganan trauma muskuloskeletal. Responden dengan pendidikan menengah memilih pengobatan tradisional sebesar 62,7%, sedangkan responden dengan pendidikan tinggi memilih pengobatan tradisional sebesar 42,9%. Responden dengan sikap yang cukup memilih pengobatan tradisional sebesar 95,6%, sedangkan responden dengan sikap yang baik memilih pengobatan tradisional sebesar 31,4%. Berdasarkan hasil uji Spearmann rho menunjukkan bahwa terdapat hubungan antara tingkat pendidikan (p=0,039) dan sikap (p=0,000) terhadap pilihan pengobatan trauma muskuloskeletal.
Simpulan: Berbagai upaya promotif dan penyuluhan kesehatan khususnya trauma muskuloskeletal perlu terus dilakukan baik dari tenaga kesehatan maupun pemegang kebijakan untuk meningkatkan sikap masyarakat dalam memilih pengobatan yang tepat serta menekan angka komplikasi akibat kesalahan penanganan trauma muskuloskeletal di Kota Banda Aceh.
Hubungan bayi berat lahir rendah dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya, Denpasar, Bali, Indonesia
Virly Isella, I Wayan Bikin Suryawan, Made Ratna DewiOnline First: Jan 7, 2023
- Abstract
Hubungan bayi berat lahir rendah dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya, Denpasar, Bali, Indonesia
Background: Infant mortality death is still high, 24 per 1,000 live births, and this is still far from the target of the Sustainable Development Goals (SDG) to decrease the infant mortality rate to 12 per 1,000 live births in 2030. One of the causes of the high burden of infant mortality rate is neonatal sepsis. There are some risk factors that contribute to neonatal sepsis, such as low birth weight and prematurity. The aim of this study was to determine if there were a correlation between low birth weight and prematurity with neonatal sepsis in Wangaya regional general hospital.
Methods: This was an observational analytic study with a cross-sectional design. All data were obtained from secondary data from medical records of patients that were hospitalized in neonatal intensive unit care and perinatology room in Wangaya regional general hospital from January until December 2019. The collected data will be analyzed by univariate and bivariate analysis with statistical Chi-Square at a 95% confidence interval.
Results: Total samples in this study were 50 neonates. The prevalence of neonatal sepsis in this study was 12 neonates (24%), with 6 neonates having early-onset neonatal sepsis (EOS) and 6 neonates having late-onset neonatal sepsis (LOS). Seventeen neonates (34%) were in the low birth weight category, and 15 neonates (30%) were premature. In bivariate analysis, we found that low birth weight had a p-value of 0.009, a prevalence ratio of 3.9, with a 95% CI of 1.36 – 11.07. Meanwhile, prematurity had a p-value of 0.003 with a prevalence ratio of 4.7, with a 95% CI of 1.66 – 13.16.
Conclusion: There was a correlation between low birth weight and prematurity with neonatal sepsis in Wangaya regional general hospital.
Latar Belakang: Angka kematian neonatus hingga saat ini masih cukup tinggi yaitu 24 per 1.000 kelahiran hidup dan belum mencapai target Sustainable Development Goals (SDG) yaitu menurunkan angka kematian neonatus menjadi 12 per 1.000 kelahiran hidup pada tahun 2030. Salah satu penyebab tingginya angka kematian neonatus adalah sepsis neonatorum. Terdapat beberapa faktor risiko yang menyebabkan sepsis neonatorum, antara lain bayi berat lahir rendah (BBLR) dan prematuritas. Tujuan penelitian ini adalah untuk mengetahui hubungan antara BBLR dan prematuritas dengan kejadian sepsis neonatorum di RSUD Wangaya.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan cross-sectional. Data penelitian diambil dari data sekunder, berupa rekam medis pasien yang dirawat di ruangan Perina dan Neonatal Intensive Care Unit (NICU) RSUD Wangaya pada periode Januari – Desember 2019. Data yang berhasil dikumpulkan akan dilakukan analisis bivariat menggunakan uji statistik Chi-Square pada interval kepercayaan (IK) 95%.
Hasil: Total sampel pada penelitian ini sebanyak 50 neonatus. Prevalensi sepsis neonatorum pada penelitian ini sebanyak 12 bayi (24%), dengan rincian 6 bayi (50%) menderita sepsis neonatal awitan dini (SNAD) dan sisanya 6 bayi (50%) menderita sepsis neonatal awitan lambat (SNAL). Jumlah bayi BBLR sebanyak 17 bayi (34%) dan prematur sebanyak 15 bayi (30%). Hasil analisis bivariat didapatkan faktor BBLR memiliki p-value 0,009; rasio prevalens (RP) 3,9 dengan 95% IK 1,36 – 11,07, sedangkan faktor prematuritas memiliki p-value 0,003; RP 4,7 dengan 95% IK 1,66 – 13,16.
Simpulan: Terdapat hubungan antara BBLR dan prematuritas dengan sepsis neonatorum di RSUD Wangaya.
Hubungan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh pada pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha selama periode 2019-2021
I Gusti Ayu Tania Dwi Cahyanti, Sony Wijaya, Welly Hartono RuslimOnline First: Mar 1, 2023
- Abstract
Hubungan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh pada pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha selama periode 2019-2021
Background: Breast cancer is a malignancy that occurs in the breast tissue of the ductal epithelium and lobules of the breast. Indonesia, in this case, ranked first out of the four countries with the highest number of breast cancer cases, namely 58.265 new cases found and 22.692 death cases. Goldhirsch et al. found a classification of breast cancer based on the results of immunohistochemistry (IHC) staining of estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) receptors using fluorescent in situ hybridization. The classification was determined genetically and molecularly, namely: luminal A, luminal B, HER2- overexpressed cancer and triple negative (basal like) cancer. Obesity which is rated using the body mass index (BMI) is one of the risk factors for some cancers, including postmenopausal breast cancer and especially estrogen receptor (ER)-positive/progesterone receptor (PR)-positive breast cancer. Rose et al stated that obesity is inversely related to pre-menopausal breast cancer, where obesity is a protective factor.
Methods: The research plan for this research is research with a cross-sectional research design which will be using purposive sampling type of non-probability sampling as the sample selection technique.
Result: There are 94 medical records of breast cancer patients who visit Rumah Sakit Umum Ganesha (Ganesha Public Hospital). The value found from the analysis that has been done between the intrinsic subtype and BMI (body mass index) risk factors is p>0.05 which means there is no correlation between the two.
Conclusion: There is no relationship between the patient’s body mass index (BMI) with intrinsic subtypes in breast cancer patients.
Latar Belakang: Kanker payudara merupakan keganasan pada jaringan payudara yang berasal dari epitel duktus maupun lobulusnya. Indonesia merupakan peringkat pertama dari empat negara yang memiliki jumlah kasus kanker payudara tertinggi yaitu sebesar 58.265 kasus baru yang ditemukan dan sebanyak 22.692 kasus mengalami kematian. Goldhirsch et al. menemukan klasifikasi kanker payudara berdasarkan hasil pewarnaan imunohistokimia (IHK) dari reseptor estrogen, progesteron, dan human epidermal growth factor receptor 2 (HER2) menggunakan hibridisasi in situ fluoresen. Klasifikasi tersebut ditentukan secara genetik dan molekuler, yaitu: kanker luminal A, luminal B, HER2- yang diekspresikan secara berlebihan dan kanker triple negative (basal like). Obesitas yang dinilai melalui indeks massa tubuh (IMT) merupakan salah satu faktor risiko timbulnya beberapa kanker, termasuk pascamenopause kanker payudara dan khususnya reseptor estrogen (ER)-positif/ reseptor progesterone (PR)-positif kanker payudara. Rose et al menyebutkan bahwa obesitas berbanding terbalik dengan perimenopause kanker payudara, dimana obesitas merupakan faktor protektif.
Metode: Rancangan penelitian ini menggunakan desain penelitian cross-sectional dengan pemilihan sampel menggunakan teknik non-probability sampling jenis purposive sampling.
Hasil: Didapatkan 94 rekam medis pasien kanker payudara yang datang di Rumah Sakit Umum Ganesha. Dari hasil analisis yang dilakukan antara subtipe intrinsik dengan faktor risiko indeks massa tubuh (IMT) memiliki nilai p>0.05 yang memiliki arti tidak terdapat hubungan antara keduanya.
Simpulan: Tidak terdapat hubungan antara indeks massa tubuh (IMT) pasien dengan subtipe intrinsik pada pasien kanker payudara.
Rasio perbandingan nilai transepidermal water loss (TEWL) dan power of hydrogen (PH) lesi psoriatic dan non-lesi psoriatic
Putu Gde Hari Wangsa, Ketut Kwartantaya Winaya, I Gusti Ayu Agung Elis Indira, I Gusti Ayu Agung Praharsini, I Gusti Nyoman Darmaputra, Ni Made Dwi Puspawati, Made WardhanaOnline First: Jan 27, 2023
- Abstract
Rasio perbandingan nilai transepidermal water loss (TEWL) dan power of hydrogen (PH) lesi psoriatic dan non-lesi psoriatic
Introduction: Psoriasis is a chronic inflammation of the skin. The remission rate of psoriasis is 10-60%, with the risk of depression, skin cancer and suicide. Inflammation leads decrease of skin hydration, and pH, thus it makes destruction of skin barrier. Therefore, this study aimed to determine the function and integrity of the skin barrier as seen from TEWL and pH in psoriatic and non-psoriatic lesions in psoriasis vulgaris patients.
Method: This was a crossectional study, that was conducted in RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar around May – July 2022. This study used a consecutive sampling technique, after that the sample was adjusted with the inclusion and exclusion criteria. The data was analyzed by using SPSS version 25. Bivariate analysis used Independent T-Test, for the multivariate analysis used linear regression.
Results: This study obtained 28 samples with the majority was male (60.7%). The average age of the sample was 45.68±15.04. The mean TEWL value in the psoriatic lesion group (24.78 ± 4.77) was higher and the mean pH was lower (5.25 ± 0.18) than the non-psoriatic lesion (TEWL:11.75 ± 2.79; pH 5.63 ± 0.21). TEWL and pH ratio between psoriatic lession and non psoriatic lesion is (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). The difference was statistically significant (p<0,01).
Conclusion: There was a significant relationship between an increase in TEWL value and a decrease in pH value in the psoriatic group of lesions compared to the non-psoriatic group.
Latar Belakang : Psoriasis merupakan penyakit inflamasi kronis pada kulit. Psoriasis dilaporkan memiliki tingkat remisi yang tinggi sebesar 10-60%, dengan risiko depresi, kanker kulit, dan bunuh diri. Inflamasi dapat menyebabkan penurunan hidrasi dan PH kulit, sehingga menyebakan kerusakan barrier kulit. Tujuan dari penelitian ini adalah untuk mengetahui fungsi dan integritas barrier kulit dilihat dari TEWL dan pH pada lesi psoriatic dan non-lesi psoriatic pada pasien psoriasis vulgaris.
Metode: Penelitian ini merupakan penelitian potong lintang yang dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar, dilakukan pada bulan Mei – Juli 2022. Teknik pengambilan sampel yang digunakan yaitu consecutive sampling dan diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah di tentukan. Data di analisis menggunakan SPSS versi 25. Analisis bivariat menggunakan Independent T-Test, dan analisis multivariat yang digunakan menggunakan regresi linear.
Hasil : Penelitian ini mendapatkan 28 sampel dengan mayoritas berjenis kelamin laki-laki (60,7%). Rata-rata sampel berusia 45,68±15,04. Rerata nilai TEWL pada pada kelompok lesi psoriatic (24,78 ± 4,77) lebih tinggi dan rerata pH lebih rendah (5,25 ± 0,18) dibandingkan non-lesi psoriatic (TEWL:11,75 ± 2,79; pH 5,63 ± 0,21). Rasio TEWL dan pH lesi psoriatic dibandingkan non-lesi psoriatic adalah (TEWL: 2,19 ± 0,11; pH 0,93 ± 0,01). Perbedaan tersebut signifikan secara statistik (p<0,01).
Simpulan: Adapun kesimpulan dari penelitian ini yakni lesi psoriatic secara signifikan memiliki nilai TEWL yang lebih tinggi namun pH yang lebih rendah dengan rasio TEWL sebesar 2,19 ± 0,11 dan rasio pH sebesar 0,93 ± 0,01.
Overview of fractures caused by The 2018 Lombok earthquake in Radiology Department of General Hospital of North Lombok Regency West Nusa Tenggara, Indonesia
Fauzy Ma’ruf, Wiwik Sari AprianturiOnline First: Jan 6, 2023
- Abstract
Overview of fractures caused by The 2018 Lombok earthquake in Radiology Department of General Hospital of North Lombok Regency West Nusa Tenggara, Indonesia
Introduction: The Lombok earthquake that occurred in July-August 2018 has caused many casualties, both deaths and injuries. North Lombok regency is the district that suffered the most fatalities. Therefore, the data on the number of patients examined in the radiology department of the General Hospital of North Lombok Regency can provide an overview of the condition of injured victims in the district. This retrospective research aims to provide an overview of fracture patients of Lombok earthquake victims conducted in the radiology department.
Method: The data were collected from the medical records of Lombok earthquake victims who were examined in the Radiology department during August 2018.
Result: A total of 378 patients were examined. From the x-ray examination, 111 victims suffered fractures. Most of the victims were female and aged >15 to 65 years old. Most of them suffered single region fractures (75 victims) and multiple region fractures (36 victims). Meanwhile, the most fractures suffered by the victims were the lower limb fractures identified in 60 victims (54%) and the shoulder-upper limb fractures found in 32 victims (28.9%). The remaining 19 victims suffered fractures of ankle –foot, wrist-hand, head, ribs, spine and pelvis.
Conclusion: The 2018 Lombok earthquake has had a health impact and increased morbidity and mortality, a total of 111 victims experienced fractures in the earthquake.
Hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun 2022
Bagus Indra Nagastya, I Dewa Ayu Inten Dwi Primayanti , Luh Putu Ratna Sundari, I Putu Adiartha GriadhiOnline First: Jan 31, 2023
- Abstract
Hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana tahun 2022
Introduction: Dysmenorrhea is pain that is quite severe during menstruation which interferes with daily activities and habits. Women who suffer from dysmenorrhea are about 50% of the world's population. Prostaglandin levels that are out of balance in primary dysmenorrhea lead to pain through increased uterine contractility, decreased uterine blood flow, and increased sensitivity of peripheral nerves. Coffee drinking is one of the risk factors for primary dysmenorrhea. This study aims to determine the association between coffee consumption and primary dysmenorrhea of female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana.
Methods: This is an analytic study with a cross-sectional approach. The research sample was selected randomly by purposive random sampling technique. The data obtained were then processed and analyzed using Microsoft Excel and SPSS.
Results: The study was conducted on 95 female students of bachelor of medicine programs batch 2021, Faculty Of Medicine, Universitas Udayana. Based on analysis tests, it was found that there was a significant association between coffee consumption and the incidence of primary dysmenorrhea (p = 0,003). The results of the odds ratio (OR) test were 4.03, thus female students who consumed coffee may have a risk of primary dysmenorrhea of 4.03 times.
Conclusion: There is a significant association between coffee consumption and the incidence of primary dysmenorrhea in female students bachelor of medicine programs batch 2021, Faculty Of Medicine, Udayana University.
Pendahuluan: Dismenore adalah rasa nyeri cukup parah pada masa menstruasi yang mengganggu aktivitas dan kebiasaan sehari-hari. Wanita yang menderita dismenore yaitu sekitar 50% dari populasi dunia. Dismenore primer disebabkan oleh ketidakseimbangan level prostaglandin yang menciptakan rasa sakit karena meningkatnya kontraktilitas uterus, penurunan aliran darah uterus, dan peningkatan sensitivitas saraf perifer. Konsumsi kopi merupakan salah satu faktor risiko dari dismenore primer. Penelitian ini memiliki tujuan untuk mengevaluasi hubungan antara konsumsi kopi dan dismenore primer pada mahasiswi Program Studi Sarjana Kedokteran Fakultas Kedokteran Universitas Udayana (PSSK FK UNUD) angkatan 2021.
Metode: Penelitian menggunakan studi analitik dengan desain cross-sectional. Teknik pengambilan sampel adalah purposive random sampling. Data yang diperoleh selanjutnya diolah dan dianalisis menggunakan perangkat lunak Microsoft Excel dan SPSS.
Hasil: Penelitian dilakukan pada 95 mahasiswi PSSK FK UNUD angkatan 2021. Berdasarkan uji analisis, didapatkan hubungan signifikan antara konsumsi kopi (p = 0,003). Hasil dari pengujian odds ratio (OR) didapat sebesar 4,03 sehingga mahasiswi yang mengonsumsi kopi memiliki risiko terjadinya dismenore primer sebesar 4,03 kali.
Simpulan: Terdapat terdapat hubungan yang bermakna antara konsumsi kopi dengan kejadian dismenore primer pada mahasiswi PSSK FK UNUD angkatan 2021.
Manifestasi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017
Lisa Alverina, I Gusti Ayu Febi Risantari, I Wayan Hendrawan, Dedianto Hidajat, I Gusti Agung Ayu Ratna Medikawati, Dinie Ramdhani KusumaOnline First: Jan 7, 2023
- Abstract
Manifestasi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017
Introduction: Indonesian Ministry of Health gave a third dose (booster) which was prioritized by the medical staff within 3 months since the second dose was given. The vaccine used for a booster is mRNA-1273 (Moderna) which had been approved by FDA (Food and Drug Administration) with modality mRNA and considerable efficacy. The adverse reaction to the skin which may present post-Moderna vaccination is a local reaction on the injection site on the first dose and increased on the second dose, delayed large local reaction on the first dose and decreased on the second dose. This study aims to determine the characteristics of dermatological lesions in the co-occurrence of post-COVID-19 booster Moderna vaccination in profession stage students of the Faculty of Medicine, Universitas Mataram, class of 2015-2017.
Method: The research design used was descriptive by taking data from respondents who received the Moderna booster who were students of the Faculty of Medicine, Universitas Mataram, class 2015-2017 and were willing to fill out a questionnaire.
Result: It was found that there were adverse reactions after vaccination as many as 90 respondents of 100 respondents with skin manifestations after Moderna booster vaccination, such as pain in the injection area (84%), edema (40%), erythema of the injection area (27%), itching (8%), urticaria (3%) and angioedema (1%). The onset of most symptoms occurred at 12-24 hours post-injection (33.3%) and 6-12 hours post-injection (23.3%).
Conclusion: There were skin manifestations in most of the respondents who received the Moderna vaccine booster (90%), with the most symptoms onset at 12-24 hours post-injection 33.3%.
Latar Belakang: Kementerian Kesehatan Republik Indonesia memberikan vaksinasi dosis ketiga (booster) yang diutamakan untuk tenaga kesehatan dengan jarak minimal 3 bulan setelah dosis kedua. Pemberian vaksin booster berupa vaksin mRNA-1273 (Moderna) yang diakui oleh FDA (Food and Drug Administration) dengan modalitas mRNA dan memiliki efikasi yang cukup besar. Efek samping pada kulit yang dapat muncul pasca vaksinasi Moderna adalah reaksi lokal pada tempat injeksi pada dosis pertama dan meningkat pada dosis kedua, delayed large local reaction pada dosis pertama dan menurun pada dosis kedua.
Tujuan: Penelitian ini bertujuan untuk mengetahui karakteristik lesi dermatologi pada kejadian ikutan pasca vaksinasi COVID-19 booster Moderna pada mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017.
Metode: Desain penelitian yang digunakan adalah deskriptif dengan cara mengambil data dari responden penerima booster Moderna yang merupakan mahasiswa tahap profesi Fakultas Kedokteran Universitas Mataram angkatan 2015-2017 dan bersedia mengisi kuesioner.
Hasil: Dari penelitian yang dilakukan didapatkan adanya kejadian ikutan pasca vaksinasi sebanyak 90 responden dari 100 responden dengan manifestasi kulit pasca vaksinasi booster Moderna berupa nyeri pada daerah injeksi (84%), edema (40%), eritema daerah injeksi (27%), gatal (8%), urtikaria (3%) dan angioedema (1%). Awitan timbulnya gejala terbanyak pada 12-24 jam pasca injeksi (33,3 %) dan 6-12 jam pasca injeksi (23,3%).
Simpulan: Terdapat manifestasi kulit pada sebagian besar responden yang menerima booster vaksin Moderna (90%) dengan awitan timbulnya gejala terbanyak pada 12 jam-24 jam pasca injeksi sebesar 33,3%.
Hubungan glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe-2 di RSUD Kabupaten Lombok Utara
Desak Made Paramestri Dyah Parameswari, Kadek Dwi Pramana, HardinataOnline First: Mar 7, 2023
- Abstract
Hubungan glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe-2 di RSUD Kabupaten Lombok Utara
Latar Belakang : DM merupakan penyakit yang umum terjadi yakni sebesar 425 juta orang dengan angka mortalitas sebesar 1,5 juta orang. Komplikasi kronis dari DM tipe 2 dapat berupa komplikasi mikrovaskular dan makrovaskular. DM tipe 2 yang tidak terkontrol akan menyebabkan terjadinya hipertensi. Hal ini dapat dicegah sedini mungkin dengan menilai pemeriksaan rutin kadar glukosa darah dan tekanan darah, namun masih sedikit dokumentasi penelitian mengenai hubungan kadar glukosa pada pasien DM dengan kejadian hipertensi. Oleh karenanya, peneliti tertarik melakukan penelitian untuk mengetahui hubungan glukosa darah puasa dengan hipertensi pada pasien DM tipe 2 yang dirawat jalan di RSUD Kabupaten Lombok Utara
Metode Penelitian : Penelitian ini merupakan penelitian analitik observasional dengan desain penelitian cross sectional menggunakan metode purposive sampling pada data Rekam Medis pasien DM yang memenuhi kriteria inklusi yakni pasien yang terdiagnosis menderita DM tipe 2 oleh dokter apabila GDP ≥ 126 mg/dl dan pasien yang berusia 18 tahun dan ekslusi yakni pasien DM dengan keadaan tertentu (HIV, CKD, Keganasan) serta pasien yang menjalani kemoterapi di RSUD Kabupaten Lombok Utara
Hasil Penelitian : Total terdapat 329 responden yang termasuk dalam penelitian ini dengan rerata usia adalah 50-60 tahun dan mayoritas jenis kelamin perempuan (66%). Ditemukan dari seluruh responden dengan kontrol glikemik yang terkontrol sebesar 13,4% dan kejadian hipertensi terjadi sebanyak 35,9%. Berdasarkan hasil uji Chi-square diperoleh bahwa Hasil analisis bivariat menunjukkan bahwa nilai p-value < 0,05 (p-value = 0,006).
Kesimpulan : Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa terdapat hubungan yang signifikan antara kadar glukosa darah puasa dengan hipertensi pada pasien diabetes melitus tipe 2 di RSUD Kabupaten Lombok Utara.
Karakteristik pasien fraktur pelvis di unit gawat darurat RSUP Prof. dr. I.G.N.G Ngoerah periode januari 2019 – september 2022
I Gusti Ayu Devina Putri Aryana, Putu Feryawan Mergawa, Made Agus MaharjanaOnline First: Jan 9, 2023
- Abstract
Karakteristik pasien fraktur pelvis di unit gawat darurat RSUP Prof. dr. I.G.N.G Ngoerah periode januari 2019 – september 2022
Introduction: The high mortality rate due to pelvic fractures in Indonesia requires the latest data regarding case descriptions related to the causes of pelvic fracture incidents, treatment and complications that can be caused.
Methods: The study design is a retrospective descriptive study with a cross-sectional approach. The sample population was determined by total sampling, namely all patients with pelvic fractures who received treatment at the ER of Prof. Dr. I.G.N.G Nogerah Denpasar. All data were taken from medical records and then analyzed descriptively. The independent variables in this study were age, gender, mechanism of injury, classification of Young-Burges and Tile fractures, emergency management of pelvic fractures and acute complications experienced. While the dependent variable was the incidence of pelvic fractures.
Results: A total of 75 samples of pelvic fracture cases were obtained for the period January 2019 to September 2022. Men dominated the majority of pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah from January 2019 – September 2022 with a proportion of 64%. Most of the cases were adults aged 25-59 years (66.67%) with the mechanism of injury most often caused by traffic accidents (77.3%). Most cases of pelvic fractures that occur fall into the category of stable pelvic fractures with the Young Burges APC II classification (18.7%) and the Tile A1 classification (14.7%). More than half of the cases (58.7%) of pelvic fractures were treated operatively with the most common procedure being ORIF PS (90.9%). There were 14 cases that experienced acute complications, where most cases of pelvic fractures were accompanied by internal organ injuries (64.3%) and hypovolemic shock (71.4%).
Conclusion: Most pelvic fracture cases at Prof. Dr. I.G.N.G Ngoerah Denpasar Hospital was treated operatively and 19% of them experienced acute complications. Future studies should focus on tracing the causes of acute complications that occur to achieve more effective and efficient management of pelvic fracture cases.
Pendahuluan: Tingginya angka mortalitas akibat fraktur pelvis di Indonesia membutuhkan data terbaru terkait gambaran kasus yang berhubungan dengan penyebab kejadian insiden fraktur pelvis, penanganan serta komplikasi yang dapat disebabkan.
Metode: Desain studi yaitu penelitian deskriptif retrospektif dengan pendekatan potong lintang. Populasi sampel ditentukan secara total sampling yaitu seluruh pasien dengan fraktur pelvis yang mendapatkan penanganan di UGD RSUP Prof. Dr. I.G.N.G Nogerah Denpasar. Seluruh data diambil dari rekam medis dan kemudian dianalisis secara deskriptif. Variabel bebas dalam penelitian ini adalah usia, jenis kelamin, mekanisme cidera, klasifikasi fraktur Young-Burges dan Tile, penanganan darurat fraktur pelvis dan komplikasi akut yang dialami. Sementara variabel tergantung adalah kejadian fraktur pelvis.
Hasil: Sebanyak 75 sampel kasus fraktur pelvis didapatkan untuk periode Januari 2019 hingga September 2022. Laki-laki mendominasi sebagian besar kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah dari Januari 2019 – September 2022 dengan proporsi 64%. Sebagian besar kasus merupakan orang dewasa berusia 25-59 tahun (66,67%) dengan mekanisme cidera yang paling sering disebabkan oleh kecelakaan lalu lintas (77,3%). Sebagian besar kasus fraktur pelvis yang terjadi masuk dalam kategori fraktur pelvis stabil dengan klasifikasi Young Burges APC II (18,7%) dan klasifikasi Tile A1 (14,7%). Lebih dari setengah jumlah kasus (58,7%) fraktur pelvis ditangani secara operatif dengan tindakan yang paling sering adalah ORIF PS (90,9%). Terdapat sebanyak 14 kasus yang mengalami komplikasi akut, dimana sebagian besar kasus fraktur pelvis disertai dengan cidera organ dalam (64,3%) dan syok hipovolemik (71,4%).
Simpulan: Kasus fraktur pelvis di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar sebagian besar ditangani secara operatif dan 19% diantaranya mengalami komplikasi akut, studi selanjutnya agar dapat fokus pada penelusuran penyebab komplikasi akut yang terjadi untuk mencapai tatalaksana kasus fraktur pelvis yang lebih efektif dan efisien.
Uji daya hambat minyak atsiri kulit buah jeruk bali (Citrus maxima) terhadap bakteri Pseudomonas aeruginosa
I Gede Krisna Arim Sadeva, Ni Nyoman Sri Budayanti, Made Agus Hendrayana, I Dewa Made SukramaOnline First: Jan 31, 2023
- Abstract
Uji daya hambat minyak atsiri kulit buah jeruk bali (Citrus maxima) terhadap bakteri Pseudomonas aeruginosa
Background: Pseudomonas aeruginosa is a gram-negative bacterium that is commonly associated with Healthcare-Associated infections (HAI), particularly Multidrug-resistance (MDR) P. aeruginosa. The polyphenolic compounds found in the peel of pomelo (C. maxima) are reported to have shown an effective antimicrobial effect. Therefore, this study aimed to investigate the inhibitory effect of C. maxima peel essential oil on the growth of P. aeruginosa bacteria.
Methods: This in vitro study evaluates the inhibitory effect of C. maxima peel essential oil against clinical isolate strains (SP47) and MDR P. aeruginosa by measuring the diameter of the inhibition zone (mm). Five series of essential oil concentrations (20%, 40%, 60%, 80%, and 100%) and the control group were used in the paper disk diffusion test with three repetitions (triplet). All data were statistically analyzed using SPSS ver. 20.
Results: A total of 4.85 mL of essential oil from 7.2 kg of C. maxima fruit peel was obtained. Inhibition zones were observed in clinical isolates of P. aeruginosa by concentrations of 60%, 80%, 100%, and K+ with means of 6.27±0.08 mm; 6.71±0.19 mm; 9.08±0.29 mm; and 40.8±0.48 mm, respectively. In MDR P. aeruginosa, the inhibition zone by concentrations of 80%, 100%, and K+ with means of 6.45±0.13 mm; 7.15±0.13 mm; and 9.08±0.34 mm, respectively. There was a significant difference in the mean diameter within groups (p<0.05).
Conclusion: C. maxima fruit peel essential oil was able to inhibit the growth of P. aeruginosa bacteria, both clinical and MDR isolates. There were differences in inhibition between the concentration series.
Metode: Penelitian ini merupakan studi in vitro yang mengevaluasi daya hambat minyak atsiri kulit buah C. maxima terhadap strain isolat klinis (SP47) dan MDR P. aeruginosa melalui pengukuran diameter zona hambat (mm). Sebanyak lima seri konsentrasi minyak atsiri (20%, 40%, 60%, 80%, dan 100%) dan kelompok kontrol digunakan dalam uji paper disk diffusion dengan pengulangan sebanyak tiga kali (triplet) Seluruh data dianalisis secara statistik menggunakan SPSS ver. 20.
Hasil: Sebanyak 4,85 mL minyak atsiri dari 7,2 kg kulit buah C. maxima diperoleh dengan metode destilasi uap. Zona hambat teramati pada isolat klinis P. aeruginosa oleh konsetrasi 60%, 80%, 100%, dan K+ dengan rerata sebesar 6,27±0,08 mm; 6,71±0,19 mm; 9,08±0,29 mm; dan 40,8±0,48 mm berturut-turut. Zona hambat juga teramati pada isolat MDR P. aeruginosa oleh konsetrasi 80%, 100%, dan K+ dengan rerata sebesar 6,45±0,13 mm; 7,15±0,13 mm; dan 9,08±0,34 mm berturut-turut. Terdapat perbedaan rerata diameter yang signifikan antar kelompok uji (p<0,05).
Simpulan: Minyak atsiri kulit buah C. maxima mampu menghambat pertumbuhan bakteri P. aeruginosa baik isolat klinis maupun MDR. Adapun terdapat perbedaan daya hambat antar seri konsentrasi.
Kata kunci: antimikroba, citrus maxima, minyak atsiri, multidrug resistant
Hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia
Rogerio Andrez Kosasih, Luh Oliva Saraswati Suastika, Cyndiana Widia Dewi Sinardja, I Gusti Ngurah Bagus ArtanaOnline First: Jan 10, 2023
- Abstract
Hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia
Introduction: The prevalence of Rheumatic heart disease (RHD) was reported to reach 30 million cases worldwide with mortality up to 305,000 people each year. RHD can be accompanied by rheumatic aortic stenosis which is a narrowing of the aortic valve of the heart. Recent studies have shown that increasing age is associated with worsening of the stenosis condition caused by several mechanisms including the calcification process and cytokine dysregulation, but related research is still limited in Indonesia. This study aims to determine the correlation between the severity of aortic stenosis related to rheumatic heart disease and age at Prof. RSUP. Dr. I.G.N.G Ngoerah, Denpasar, Bali.
Method: This cross-sectional study was conducted on the population of patients with rheumatic aortic stenosis at Prof. RSUP. Dr. I.G.N.G Ngoerah. Data collection was carried out using medical records of 2018-2022 period. All data processing was carried out using the SPSS ver. 26.
Result: A total of 34 patients with rheumatic aortic stenosis were collected to be mostly <60 years old, 29 patients (85,3%) with the mean age of all patients was 48 ± 14.5 years. As many as 19 patients (55.9%) had severe, 10 patients (29.4%) had moderate, and 5 patients (14.7%) had mild stenosis severity. Bivariate analysis showed there was a significant correlation between age and severity of stenosis (r=0.501; p=0.003).
Conclusion: Therefore, this study concluded that there was a significant correlation between the severity of stenosis and age in patients with rheumatic aortic stenosis at Prof. RSUP. Dr. I.G.N.G Ngoerah.
Pendahuluan: Prevalensi Rheumatic heart disease (RHD) dilaporkan mencapai 30 juta kasus di seluruh dunia serta menjadi penyebab kematian sebanyak 305 ribu jiwa tiap tahunnya. RHD dapat disertai dengan rheumatic aortic stenosis yang merupakan penyempitan katup aorta jantung. Studi terbaru menunjukkan bahwa peningkatan usia berkaitan dengan perburukan kondisi stenosis yang disebabkan oleh beberapa mekanisme termasuk proses kalsifikasi dan disregulasi sitokin, namun penelitian terkait masih terbatas di Indonesia. Penelitian ini bertujuan untuk mengetahui hubungan tingkat keparahan stenosis aorta terkait penyakit jantung rematik dengan usia di RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, Bali.
Metode: Penelitian ini merupakan studi observasional dengan desain potong lintang dengan teknik pengumpulan data menggunakan total sampling pada populasi pasien rheumatic aortic stenosis di di RSUP Prof. Dr. I.G.N.G Ngoerah. Pengumpulan data dilakukan dengan rekam medis periode 2018-2022. Pengolahan data dilakukan menggunakan aplikasi SPSS ver.26 dengan analisis univariat dan bivariat (Uji Spearm`an’s Rho).
Hasil: Sebanyak 34 pasien rheumatic aortic stenosis diperoleh dengan sebagian besar berusia <60 tahun, yakni sebanyak 29 pasien (85,3%) dengan rerata usia seluruh pasien adalah 46,4 ± 14,7 tahun. Adapun sebanyak 19 orang (55,9%) memiliki tingkat keparahan berat (severe), 10 orang (29,4%) dengan keparahan sedang (moderate), dan 5 orang (14,7%) dengan keparahan ringan (mild). Analisis bivariat menunjukkan terdapat hubungan yang signifikan antara usia dengan tingkat keparahan stenosis pada pasien rheumatic aortic stenosis (r=0,501; p=0,003).
Conclusion: Terdapat hubungan yang signifikan antara tingkat keparahan stenosis dengan usia pada pasien rheumatic aortic stenosis di RSUP Prof. Dr. I.G.N.G Ngoerah.
Klasifikasi Etiologi Presbikusis Berdasarkan Hasil Audiogram di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Januari-Desember 2020
Pande Nyoman Bayu Tirtayasa, I Made WiranadhaOnline First: Jan 9, 2023
- Abstract
Klasifikasi Etiologi Presbikusis Berdasarkan Hasil Audiogram di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah Periode Januari-Desember 2020
Background: Presbycusis or age-related hearing loss, is the most common cause of hearing loss and also the most common neurodegenerative disorder. This age-related hearing loss occurs in the population over 60 years of age. This study aims to determine the type of presbycusis in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.
Methods: This study is a retrospective descriptive study with a total sample of 42 people taken consecutively in presbycusis patients at the ENT Polyclinic of Prof. Dr. I.G.N.G. Ngoerah Hospital for the period of January-December 2020.
Results: The results showed that the audiogram results based on the right and left ears, 42.8% and 45.2% had strial type presbycusis, 30.9% and 28.6% had cochlear type presbycusis, 21.4% and 23.8% had sensory type presbycusis, 4.8% and 2.4% had neural type presbycusis.
Conclusion: From the results of this study, it can be concluded that the average degree of deafness of the right and left ears is moderate-heavy, with the dominant type of presbycusis being the strial or metabolic type. Presbycusis shows a wide variation in the degree of deafness, hearing acuity, age of onset, and progression, so it is likely that the burden of presbycusis in the population may increase in the future.
Latar Belakang: Presbikusis atau penurunan pendengaran terkait usia, merupakan penyebab gangguan pendengaran dan sekaligus juga merupakan gangguan neurodegeneratif yang paling sering terjadi. Penurunan pendengaran terkait usia ini terjadi pada populasi usia lebih dari 60 tahun. Penelitian ini bertujuan untuk mengetahui jenis presbikusis pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.
Metode: Penelitian ini adalah penelitian deskriptif retrospektif dengan total sampel sebanyak 42 orang yang diambil secara konsekutif pada pasien presbikusis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari-Desember 2020.
Hasil: Hasil penelitian menunjukkan bahwa hasil audiogram berdasarkan telinga kanan dan kiri, sebanyak 42,8% dan 45,2% mengalami presbikusis tipe strial, 30,9% dan 28,6% mengalami presbikusis tipe koklea, 21,4% dan 23,8% mengalami presbikusis tipe sensori, sebanyak 4,8% dan 2,4% mengalami presbikusis tipe neural.
Simpulan: Dari hasil penelitian ini dapat disimpulkan bahwa derajat ketulian telinga kanan dan kiri rata-rata adalah derajat sedang-berat, dengan tipe presbikusis yang dominan adalah tipe strial atau metabolik. Presbikusis memperlihatkan variasi yang beragam pada derajat ketulian, ketajaman pendengaran, onset umur, dan progresinya sehingga kemungkinan beban presbikusis di populasi dapat meningkat di kemudian hari.
The predictive model of acute heart failure rehospitalization: A retrospective study in Prof. I.G.N.G Ngoerah Hospital
Nyoman Ririn Chandrika Sari, Hendy Wirawan, Rani Paramitha Iswari Maliawan, IGN Putra GunadhiOnline First: Feb 15, 2023
- Abstract
The predictive model of acute heart failure rehospitalization: A retrospective study in Prof. I.G.N.G Ngoerah Hospital
Introduction. Heart failure is one of the main causes of cardiovascular morbidity and mortality. Research stated that heart failure patients who have undergone 3 rehospitalizations have a survival rate of <50% within 1 year. Therefore, the purpose of this study is to characterize the risk factors that contribute to the occurrence of heart failure rehospitalization.
Method. This is a retrospective analysis of 113 patients with a first hospitalization for heart failure at Prof. I.G.N.G. Ngoerah Hospital between July 2018–February 2020. We collected and compared demographic data, clinical findings, electrocardiogram, laboratory, and echocardiography parameters during the first hospitalization between rehospitalized and non-rehospitalized patients. Rehospitalization was defined as recurrent hospital admission due to worsening heart failure symptoms. Patients were followed for rehospitalization events until death or November 2021.
Results. The rehospitalization rate in this study was 62.8% during a median follow-up of 234 days (12–1098 days). The average of heart failure rehospitalizations during follow-up was 1.73 times (±1.97), with an average length of stay of 6.40 days (±3.27 days). We discovered that the presence of mid/apical rales at admission (odds ratio [OR] 3.509; p=0.027), hyponatremia (<135 mmol/L) at pre-discharge (odds ratio [OR] 3.840; p=0.015), and tricuspid annular plane systolic excursion (TAPSE) values <1.80 cm (odds ratio [OR] 2.905; p=0.020) were independent risk factors for rehospitalization due to worsening heart failure symptoms. Patients with these three independent risk factors have a probability of 96.24% being readmitted.
Conclusion. Mid/apical rales at admission, hyponatremia at pre-discharge, and TAPSE values <1.80 cm in patients admitted for heart failure are associated with further rehospitalization.
Kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris
Aditya Permana, Made Swastika Adiguna, Luh Made Mas RusyatiOnline First: Jan 31, 2023
- Abstract
Kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris
Introduction: Psoriasis is a chronic autoimmune cutaneous disorder, which the exact etiology remains unknown. There is study showed psoriasis is associated with low levels of vitamin D. In recent years, vitamin D acted by vitamin D receptor (VDR) has been reported, which keratinocyte is one of the tissues presenting vitamin D receptor. This study aims to prove that low levels vitamin D receptor plasma is a risk factor for psoriasis vulgaris.
Method: This case-control study design in 25 patients with psoriasis vulgaris as cases and 25 controls who fulfilled the inclusion and exclusion criteria as well as in matching based on age and gender in Dermatovenereology Polyclinic of I.G.N.G Ngoerah Hosptital, then performed venous blood sampling as material examination vitamin D receptor plasma levels with enzyme-linked immunosorbent assay (ELISA) technique. The collected data was analyzed using SPSS version 20.0 with Pearson Chi square test to obtain Odds Ratio. This study showed that vitamin D receptor plasma levels in the case group were significantly lower than the control group (p<0.05).
Result: Odds ratio for vitamin D receptor plasma was 46.00 (95% CI= 8.03-263.63; p<0.001).
Conclusion: Based on these study results we can conclude low levels vitamin D receptor plasma as a risk factor the occurrence of psoriasis vulgaris.
Pendahuluan: Psoriasis merupakan penyakit kulit autoimun kronis yang belum diketahui penyebabnya dengan jelas. Terdapat penelitian yang menunjukkan psoriasis berhubungan dengan kadar vitamin D yang rendah. Beberapa tahun terakhir, terdapat penelitian yang menyatakan bahwa vitamin D bekerja melalui vitamin D receptor (VDR), dimana keratinosit merupakan salah satu jaringan yang mempresentasikan VDR. Penelitian ini bertujuan untuk membuktikan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Metode: Penelitian ini menggunakan rancangan case control study yang melibatkan 25 pasien psoriasis vulgaris sebagai kasus dan 25 kontrol yang memenuhi kriteria inklusi dan eksklusi serta dilakukan matching berdasarkan umur dan jenis kelamin di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP I.G.N.G Ngoerah Denpasar, kemudian dilakukan pengambilan darah vena sebagai pemeriksaan kadar vitamin D receptor plasma menggunakan teknik enzyme-linked immunosorbent assay (ELISA). Data yang terkumpul kemudian dianalisis menggunakan SPSS versi 20.0 dengan uji Pearson Chi Square untuk mendapatkan Odds rasio.
Hasil: Pada penelitian ini menunjukkan bahwa kadar vitamin D receptor plasma pada kelompok kasus lebih rendah secara bermakna dibandingkan kelompok kontrol (p<0,05) dengan Odds rasio untuk kadar vitamin D receptor plasma adalah 46,00 (IK 95%= 8,03-263,63, p<0,001).
Simpulan: Berdasarkan penelitian ini dapat disimpulkan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Kadar luteinizing hormone yang tinggi menjadi faktor risiko melasma pada pria
Henny Wijaya, Ketut Kwartantaya Winaya, Ni Made Dwi Puspawati, IGAA Praharsini, IGN Darmaputra, Ratih Vibriyanti KarnaOnline First: Feb 19, 2023
- Abstract
Kadar luteinizing hormone yang tinggi menjadi faktor risiko melasma pada pria
Introduction: Melasma is a hyperpigmented disorder that generally occurs on the face, mostly in women. Meanwhile, the incidence of melasma in men is still little documented, especially in studies that specifically discuss hormonal risk factors for the occurrence of melasma in men. Therefore, this study aimed to evaluate the relationship between high levels of the luteinizing hormone as a risk factor for melasma in men.
Methods: The design used is an analytic retrospective and case-control method. The research location is the Dermatology and Venereology Polyclinic, the cosmetic-medical subdivision of the Central General Hospital Prof. Dr. IGNG Ngoerah, Denpasar, Bali, from June 2022 to August 2022. The melasma samples were paired with non-melasma samples based on age, Fitzpatrick type, and duration of sun exposure. Data were obtained using medical records and analyzed univariate to multivariate through SPSS application with a p-value of 0.05.
Results: A total of 60 respondents were included in this study, 30 people with melasma cases and 30 as controls. Based on the characteristics of the respondents, the mean age was 48.83±6.30 years. Based on the analysis, several factors significantly affect the occurrence of melasma in men: family history, duration of sun exposure > 6 hours, and high serum LH. levels (p<0.05). The results of logistic regression analysis showed serum LH levels > 15.09 mIU/ml (OR: 6.986; 95%CI: 1.905-25,622; p=0.003). This result shows that the risk factor for LH serum levels of 15.09 IU/ml has a 6.9 times risk of melasma in male patients compared to those with LH levels < 15.09. The results of the Pearson correlation test showed a strong relationship between high serum LH Levels and an increase in the patient's MASI score (r=0.982; p<0.001).
Conclusion: It can be concluded that high serum LH levels are the main risk factor for melasma in men.
Latar Belakang: Melasma merupakan kelainan hiperpigmentasi yang umumnya terjadi pada daerah wajah dan mayoritas terjadi wanita. Sedangkan, kejadian melasma pada pria masih sedikit didokumentasikan, khususnya studi yang membahas secara spesifik faktor risiko hormonal terhadap terjadinya melasma pada pria. Oleh karenanya, penelitian ini bertujuan mengevaluasi hubungan antara kadar luteinizing hormone yang tinggi sebagai faktor risiko melasma pada pria.
Metode: Desain yang digunakan yakni retrospektif analitik dan metode case control. Lokasi penenlitian yakni Poliklinik Kulit dan Kelamin subdivisi kosmedik Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah, Denpasar, Bali, mulai bulan Juni 2022 hingga Agustus 2022. Sampel melasma dipasangkan dengan sampel non melasma berdasarkan usia, tipe kulit Fitzpatrick, dan lama paparan matahari. Data diperoleh dengan menggunakan rekam medis dan dianalisis secara univariat sampai multivariat melalui aplikasi SPSS dengan nilai p ≤ 0,05.
Hasil: Total terdapat 60 responden yang masuk dalam studi ini, 30 orang dengan kasus melasma dan 30 orang sebagai kontrol. Berdasarkan karakteristik responden diperoleh memiliki rerata usia 48,83±6,30 tahun. Berdasarkan analisis diperoleh beberapa faktor yang berpengaruh signifikan terhadap terjadinya melasma pada pria adalah, riwayat keluarga, lama paparan sinar matahari > 6 jam, dan tingginya kadar serum LH (p<0,05). Hasil analisis regresi logistik menunjukan kadar serum LH > 15,09 mIU/ml (AOR: 6,986; 95%CI:1,905-25,622; p=0,003). Pada hasil ini menunjukan nilai faktor risiko kadar serum LH ≥ 15,09 IU/ml memiliki risiko sebesar 6,9 kali terjadi melasma pada pasien laki-laki dibandingkan yang memiliki kadar LH < 15,09. Hasil uji korelasi Pearson menunjukan adanya hubungan kuat antara kadar serum LH tinggi dengan peningkatan skor MASI pasien (r=0,982; p<0,001)
Simpulan: Dapat disimpulkan bahwa kadar serum LH yang tinggi menjadi faktor risiko utama kejadian melasma pada pria
Psychosomatic disorder screening in health officers during the COVID-19 pandemic
Yanuar Ardani, Hamzah Shatri, Rudi Putranto, Dika Iyona Sinulingga, Edward Faisal, Rendi Faris AnggonoOnline First: Feb 13, 2023
- Abstract
Psychosomatic disorder screening in health officers during the COVID-19 pandemic
Background: Health workers are at high risk of developing depression, anxiety, and sleep disturbances due to increased stress during the COVID-19 pandemic; that matter is closely related to fatigue. The impact of psychosomatic disorders will have an immediate or indirect impact on the quality of health care services. This study aims to evaluate the psychosomatic disorder screening in health officers during the COVID-19 pandemic
Methods: A cross-sectional study was conducted in Esensia Clinic Semarang in February 2022. This study surveyed clinic health workers with completed questionnaires and had their Heart-Rate Variability (HRV) measurement. Data were analyzed using SPSS version 20 for Windows.
Results: About 138 subjects were recruited from Esensia Clinic, 100 subjects underwent this study until analysis. The unanxious subjects have the highest percentage accounting for 61.0%, followed by 25.0% mild anxiety, 12.0% moderate, and 2.0% severe. Furthermore, 86.0% were undepressed, followed by 13% mild and 1% moderate, but there was no severe case. Also, 65.0% did not experience fatigue and the percentage of good sleep quality (8.0%) is significantly lower than the poor (92.0%). The results also showed that 76.0% of the subjects had a balanced autonomic nervous system compared to the 24.0% of subjects with an autonomic imbalance.
Conclusion: The outcomes of psychosomatic disorders such as anxiety, depression, fatigue, and autonomic imbalance are generally poor. However, this study's prevalence of poor sleep quality was very high.
Prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021
Bella Trisha Agung Saraswati, I Dewa Ayu Inten Dwi Primayanti, Luh Putu Ratna Sundari, I Putu Adiartha GriadhiOnline First: Jan 11, 2023
- Abstract
Prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021
Introduction: One of the mandatory health protocols during the COVID-19 pandemic is wearing a mask. Masks that are used for a long time can increase the risk of developing acne vulgaris in the area around the mouth and nose (mask acne). The impact caused by acne masks is very detrimental both in terms of aesthetics, comfort, and psychology. This study aims to analyze the prevalence and risk factors for mask acne in undergraduate medical students and the medical profession at Udayana University class of 2019-2021.
Methods: This study has a cross-sectional design with observational analytic methods. The sample of this research was 260 respondents who were taken by consecutive sampling. Data analysis was performed by chi-square test and logistic regression.
Results: The prevalence of mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 is 50.8%. Risk factors for mask acne in students of the Faculty of Medicine, Udayana University class of 2019-2021 include skin type (p = 0.025), oily skin condition after using a mask (p <0.001), and having a history of acne vulgaris due to sunlight (p = 0.002).
Conclusion: About half of the 2019-2021 class of Udayana University Faculty of Medicine students experience mask acne with various risk factors.
Pendahuluan: Salah satu protokol kesehatan saat pandemi COVID-19 yang wajib dilakukan adalah menggunakn masker. Masker yang digunakan dalam waktu lama dapat meningkatkan risiko timbulnya acne vulgaris di area sekitar mulut dan hidung (mask acne). Dampak yang ditimbulkan mask acne sangat merugikan baik dari segi estetika, kenyamanan, dan psikologis. Penelitian ini memiliki tujuan untuk menganalisis prevalensi dan faktor risiko mask acne pada mahasiswa program studi sarjana kedokteran dan profesi dokter Universitas Udayana angkatan 2019-2021.
Metode: Penelitian ini memiliki desain cross-sectional dengan metode analitik observasional. Sampel dari penelitian ini sebanyak 260 responden yang diambil dengan cara consecutive sampling. Analissi data dilakukan dengan uji chi-square dan regresi logistik.
Hasil: Prevalensi mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 adalah 50,8%. Faktor risiko mask acne pada mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 antara lain jenis kulit (p = 0,025), kondisi kulit berminyak setelah menggunakan masker (p<0,001), dan memiliki riwayat acne vulgaris akibat sinar matahari (p = 0,002).
Simpulan: Sekitar setengah dari jumlah mahasiswa Fakultas Kedokteran Universitas Udayana angkatan 2019-2021 mengalami mask acne dengan berbagai faktor risiko.
Karakteristik klinis hidrosefalus pada anak di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G Ngoerah Denpasar tahun 2021-2022
Ni Wayan Aristia Budi Utami, Dewi Sutriani Mahalini, I Nyoman Budi Hartawan, Dyah Kanya WatiOnline First: Jan 31, 2023
- Abstract
Karakteristik klinis hidrosefalus pada anak di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G Ngoerah Denpasar tahun 2021-2022
Introduction: Hydrocephalus is pathological condition that results in disturbances of formation, flow, and absorption of cerebrospinal fluid (CSF) resulting an increase in the volume of CSF in the brain. The etiology of hydrocephalus is distinguished by congenital and acquired. Hydrocephalus in children have not been widely discussed, especially characteristics of hydrocephalus in children. This study aims to determine the characteristics of hydrocephalus in children at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022.
Methods: This research is a descriptive study using medical record data. This research was conducted at Prof. Dr. I.G.N.G Ngoerah Hospital Denpasar from September to October 2022. The sampling technique used is total sampling.
Result: As many as 73 children with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 with characteristics in the form of congenital hydrocephalus in 41 people (56.2%), the highest age group in infants (0-2 years) as many as 34 people (46.6%), in the boy group as many as 43 people (58.9%) with clinical symptoms of macrocephaly in 43 people (58.9%) and headache in 18 people (24.7%), with management of VP shunt surgery 55 people (75.3%), and patient outcome the most living are 61 people (83.6%).
Conclusion: Children suffering with hydrocephalus at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar in 2021-2022 mostly due to a congenital etiology with clinical symptoms of macrocephaly treated with VP shunt surgery and life outcomes in the age range of 0-2 years.
Pendahuluan: Hidrosefalus adalah suatu keadaan patologis yang mengakibatkan adanya gangguan pada pembentukan, aliran, maupun penyerapan cairan serebrospinal (CSS) sehingga terjadi peningkatan volume CSS pada otak. Etiologi hidrosefalus dibedakan berdasarkan kongenital dan acquired (didapat). Kasus hidrosefalus pada anak tersebut belum banyak dibahas khususnya dalam hal karakteristik penderita hidrosefalus pada anak. Tujuan penelitian ini adalah untuk mengetahui karakteristik hidrosefalus pada anak di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dari aspek etiologi, klinis, tatalaksana, dan luaran.
Metode: Penelitian ini merupakan penelitian deskriptif menggunakan data rekam medis. Penelitian ini dilaksanakan di RSUP Prof. Dr. I.G.N.G Ngoerah Denpasar pada bulan September sampai Oktober tahun 2022. Adapun teknik sampling yang digunakan adalah total sampling.
Hasil: Ditemukan 73 kasus anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 dengan karakteristik etiologi berupa hidrosefalus kongenital yaitu 41 orang (56,2%), kelompok usia tertinggi pada bayi (0-2 tahun) berjumlah 34 orang (46,6%), pada kelompok jenis kelamin laki-laki yaitu 43 orang (58,9%) dengan gejala klinis terbanyak makrosefali 43 orang (58,9%) dan nyeri kepala 18 orang (24,7%), dengan tatalaksana berupa bedah VP shunt 55 orang (75,3%), dan luaran terbanyak pasien hidup yaitu 61 orang (83,6%).
Simpulan: Anak penderita hidrosefalus di RSUP Prof. Dr. I.G.N.G. Ngoerah tahun 2021-2022 tinggi pada laki-laki, akibat etiologi kongenital dengan gejala klinis makrosefali yang ditatalaksana dengan bedah berupa VP shunt serta luaran hidup pada rentang usia 0-2 tahun.
Asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan di RSUD Wangaya Kota Denpasar
Han's Christian, Ancelia Limantara, Wayan Bikin Suryawan, I Kadek SuarcaOnline First: Mar 3, 2023
- Abstract
Asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan di RSUD Wangaya Kota Denpasar
Background: Febrile seizures are one of the most common neurological disorders during childhood. Febrile seizures' prevalence is about 2% to 5%. Electrolyte disturbance, especially hyponatremia, has been thought to be one of the factors for enhanced susceptibility to febrile seizures. This study aims to know the association between hyponatremia with febrile seizures in children ages 6 months to 60 months.
Methods: An analytical observational case-control study using medical records at Wangaya Hospital during the period between January 2020-January 2022. Inclusion criteria include patients aged 6 months to 60 months diagnosed with febrile seizure and natrium serum level measured during hospitalization. Exclusion criteria include patients who got fever after vaccination, brain defect, vascular malformation, tumors and acid and base disorder during hospitalization.
Results: Among 100 subjects, 63% were males, and 37% were females. The mean natrium level in the group of febrile seizures was 136.760 ± 5.326 mEq/L, and 136.500 ± 4.362 mEq/L in the group of fever without seizures, with an Independent t-test, showed a P-value of 0.788. No significant differences were found between hyponatremia and seizures, with the Mann-Whitney test, which showed a P-value of 0.678.
Conclusion: No significant differences were found between natrium serum level and febrile seizures. The mean natrium serum level between the febrile seizures group and the fever without seizures group showed no significant differences.
Latar Belakang: Kejang demam merupakan salah satu kelainan neurologis yang paling sering dijumpai pada anak. Prevalensi kejang demam berkisar antara 2% hingga 5%. Ketidakseimbangan elektrolit, terutama hiponatremia, bisa menjadi salah satu faktor penyebab kejang demam. Tujuan penelitian adalah mengetahui asosiasi kadar natrium dengan kejang demam pada anak usia 6 bulan hingga 60 bulan.
Metode: Penelitian ini merupakan penelitian analitik observasional dengan rancangan penelitian kasus kontrol, menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi: anak berusia 6 bulan hingga 60 bulan dengan kejang demam, dan dilakukan pemeriksaan kadar natrium selama perawatan. Kriteria eksklusi: anak yang mengalami kejang setelah dilakukan vaksinasi, memiliki defek otak, malformasi vaskular, memiliki tumor, dan memiliki kelainan pH darah saat dilakukan pemeriksaan.
Hasil: Dari 100 subjek penelitian, 63% berjenis kelamin laki-laki, 37% perempuan. Rerata kadar natrium serum pada kelompok kejang demam sebesar 136,760 ± 5,326 mEq/L dan sebesar 136,500 ± 4,362 mEq/L pada kelompok demam tanpa kejang, dengan uji nilai P 0,788 menggunakan independent t-test. Tidak terdapat hubungan antara kadar natrium dengan kejadian kejang, dengan uji nilai P sebesar 0,678 menggunakan uji Mann-Whitney dan odd ratio 1,190
Kesimpulan: Tidak ada hubungan yang signifikan antara kadar natrium dengan kejang demam. Rerata kadar natrium baik pada kelompok kejang demam dan demam tanpa kejang menunjukkan perbedaan yang tidak bermakna.
The association of comorbidities with mortality and severity among children with COVID-19
Ni Made Dwi Angga Riani, Ni Putu Siadi Purniti, Ida Bagus SubanadaOnline First: Feb 19, 2023
- Abstract
The association of comorbidities with mortality and severity among children with COVID-19
Background: Several case series have described the clinical characteristics of COVID-19 in pediatric patients and suggest milder illness severity in children compared with adults. However, some cases presented more severe diseases with small numbers of deaths have been documented. Some studies in developed countries demonstrated that the presence of comorbidities among COVID-19 patients could increase the severity of the disease. Therefore, this study aimed to identify the association of comorbidities with mortality and severity among children with COVID-19.
Methods: This was an analytic retrospective cross-sectional study conducted in Prof. Dr. IGNG Ngoerah Hospital, Denpasar, from May 2020 until March 2022. A total of 94 children aged 28 days-18 years old with confirmed COVID-19 were included in this study and divided into two groups, with comorbidities and without comorbidities. The chi-square test was used to determine the association between comorbidities and their relation to mortality and severity. The statistical significance was set at p less than 0.05.
Results: The normality test showed that the age data distribution is not normal with the median age of 72 months (IQR 45-189) and 108 months (IQR 64-240) in the comorbidities and without comorbidities group, respectively. Bivariate analysis showed there was a significant association between comorbidities with the mortality and severity among children with COVID-19 (PR 3.21; 95% CI 1.04-9.90; p= 0.036) and (PR 10.71; 95%CI 4.12-27.83; p< 0.001), respectively. The multivariate analysis revealed the comorbidities increased risk of mortality and severity with adjusted OR (aOR) 3.74 (95%CI 1.14-12.25) and adjusted OR (aOR) 11.8 (95%CI 4.35-32.41), respectively; after adjusting for age and nutritional status.
Conclusion: Comorbidities significantly affect mortality and severity among children with COVID-19.
Hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada karsinoma sel skuamosa serviks uteri di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar
Mellinda Wijaya, Ni Wayan Winarti, I Gusti Ayu Sri Mahendra Dewi, Herman Saputra, Putu Erika Paskarani, I Made MuliartaOnline First: Feb 15, 2023
- Abstract
Hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada karsinoma sel skuamosa serviks uteri di RSUP Prof. dr. I.G.N.G. Ngoerah Denpasar
Background: Cervical cancer still shows a high incidence rate in developing countries. Various factors play roles in cancer progression, including Galectin 3, which contributes to apoptosis, metastasis, immune response, molecular systems, mRNA splicing, gene expression and inflammation. This study aims to prove the association between Galectin 3 expression and FIGO stage of cervical squamous cell carcinoma (SCC) patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, to strengthen the evidence of Galectin 3 roles in cervical SCC prognosis.
Methods: This study is an analytic observational study with a cross-sectional design. Sample size was 42. Evaluation of H-E slides was performed to assess diagnosis and FIGO. Galectin 3 expression was assessed by immunohistochemical method. Data were analyzed by Chi-Square test and prevalence risk ratio analysis using SPSS version 20.0 for Windows.
Results: The mean of patients age was 52.34±9.86 years, with the highest incidence in the sixth decade age and in the early FIGO stage (IB - IIA). About 81% of patients show positive Galectin 3 expression. The relationship between Galectin 3 expression and FIGO stage was statistically significant (p=0.016). The prevalence risk analysis showed that patients with positive Galectin 3 expression had a 1.9 times greater prevalence risk of developing an advanced stage than patients with negative expression (95% CI: 1.376 - 2.593).
Conclusion: There is an association between Galectin 3 expression and FIGO stage in cervical cancer patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, in which patients with positive Galectin 3 have a greater risk of developing an advanced stage.
Latar Belakang : Kanker serviks uteri masih menunjukkan angka insiden tinggi di negara berkembang. Berbagai faktor berperan dalam progresi kanker, salah satunya Galectin 3, yang berkontribusi dalam proses apoptosis, metastasis, respon imun, sistem molecular, mRNA splicing, ekspresi gen dan inflamasi. Penelitian ini bertujuan untuk membuktikan hubungan ekspresi Galectin 3 dengan stadium FIGO pasien karsinoma sel skuamosa (KSS) serviks di RSUP Prof. Dr. I.G.N.G. Ngoerah, untuk memperkuat bukti peran Galectin 3 pada prognosis KSS serviks.
Metode: Penelitian ini merupakan penelitian observasional analitik dengan rancangan potong lintang. Besar sampel 42. Evaluasi preparat hematoxyllin-eosin dilakukan untuk menilai diagnosis dan stadium FIGO. Ekspresi Galectin 3 dinilai dengan metode imunohistokimia. Data dianalisis dengan uji Chi-Square, yang dilanjutkan dengan uji rasio risiko prevalensi menggunakan SPSS versi 20.0 untuk Windows.
Hasil: Rerata usia pasien 52,34±9,86 tahun, dengan kejadian tertinggi pada kelompok umur dekade keenam dan dengan stadium FIGO dini (IB - IIA). Sekitar 81% pasien menunjukkan ekspresi Galectin 3 positif. Hubungan antara ekspresi Galectin 3 dengan stadium FIGO ditemukan signifikan secara statistik (p=0,016). Pada analisis risiko prevalensi didapatkan pasien dengan ekspresi Galectin 3 positif memiliki risiko prevalensi 1,9 kali lebih besar menjadi stadium lanjut daripada pasien dengan ekspresi negatif (95% IK: 1,376 - 2,593).
Kesimpulan: Terdapat hubungan antara ekspresi Galectin 3 dengan stadium FIGO pada pasien KSS serviks di RSUP Prof. Dr. I.G.N.G. Ngoerah, di mana pasien dengan Galectin 3 positif memiliki risiko lebih besar menjadi stadium lanjut.
Karakteristik pasien ptosis di Rumah Sakit Umum Pusat Prof. dr. I G.N.G. Ngoerah
Putri Ayu Wulandari, Ni Made Laksmi Utari, Ni Made Ayu Surasmiati, I Gusti Ayu Ratna SuryaningrumOnline First: Jan 10, 2023
- Abstract
Karakteristik pasien ptosis di Rumah Sakit Umum Pusat Prof. dr. I G.N.G. Ngoerah
Background: Ptosis or blepharoptosis is a condition where the eyelid droops below its normal position. Ptosis can affect the visual field by reducing the patient's visual acuity. Ptosis is also considered a problem in appearance because the patient will always look tired and sleepy. If not treated immediately, ptosis can cause further complications, such as refractive errors, strabismus, and amblyopia. The purpose of this study is to identify the demographic and clinical characteristics of ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital.
Methods: This descriptive study with a cross-sectional design and total sampling was carried out at Prof. dr. I G.N.G. Ngoerah Hospital with ptosis patient data in 2019-2021.
Results: There were 45 ptosis patients at Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021. In this study, the majority of ptosis patients were male. (53.3%). Patients in this study had a mean age of 37.91±23.55 years old with a median of 33(1-85). Unilateral ptosis (88.9%) and acquired ptosis (73.3%) were the most common ptosis cases found in this study. There are three etiologies that dominate ptosis cases, namely neurogenic (28.9%), traumatic (28.9%), and myogenic (26.7%) ptosis. Most of the ptosis patients have a severe degree of ptosis (60.0%). As many as 80% of ptosis patients receive surgical management.
Conclusion: Ptosis cases in Prof. dr. I G.N.G. Ngoerah Hospital in 2019-2021 were dominated by male patients, unilateral ptosis, acquired ptosis, neurogenic, and severe degree. Further research is required to evaluate the association between variables. with a larger population.
Latar Belakang: Ptosis atau blepharoptosis merupakan kondisi turunnya kelopak mata di bawah posisi normal. Ptosis dapat memengaruhi lapang pandang dengan mengurangi ketajaman visual pasien. Ptosis juga dianggap sebagai permasalahan dalam penampilan dikarenakan pasien akan selalu terlihat kelelahan dan mengantuk. Apabila tidak segera ditangani, ptosis dapat menyebabkan terjadinya komplikasi lebih lanjut, seperti kelainan refraksi, strabismus, dan ambliopia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik demografis dan klinis pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah.
Metode: Penelitian deskriptif dengan desain cross-sectional dan penentuan sampel secara total sampling ini dilaksanakan di RSUP Prof. dr. I G.N.G. Ngoerah dengan data pasien ptosis pada tahun 2019-2021.
Hasil: Pasien ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 berjumlah 45 orang. Sebagian besar pasien ptosis dalam penelitian ini berjenis kelamin laki-laki (53,3%). Pasien dalam penelitian ini memiliki rerata usia 37,91±23,55 tahun dengan median 33 (1-85). Ptosis unilateral (88,9%) dan acquired ptosis (73,3%) merupakan kasus ptosis yang mendominasi dalam penelitian ini. Terdapat tiga etiologi yang mendominasi kasus ptosis pada pasien, yaitu ptosis neurogenik (28,9%), traumatik (28,9%), dan miogenik (26,7%). Sebagian besar pasien ptosis memiliki derajat keparahan dalam kategori berat (60,0%). Sebanyak 80% dari pasien ptosis menerima tatalaksana operasi.
Simpulan: Kasus ptosis di RSUP Prof. dr. I G.N.G. Ngoerah pada tahun 2019-2021 didominasi oleh pasien laki-laki, ptosis unilateral, acquired ptosis, neurogenik, dan derajat berat. Penelitian lebih lanjut diperlukan untuk menilai hubungan antar variabel dengan populasi yang lebih besar.
Karakteristik pasien diabetic retinopathy dengan dislipidemia di RSUP Sanglah Denpasar
Putu Andrea Wisnu Sebastian, Made Agus Kusumadjaja, I Gusti Ayu Made Juliari, I Gusti Ayu Ratna SuryaningrumOnline First: Jan 10, 2023
- Abstract
Karakteristik pasien diabetic retinopathy dengan dislipidemia di RSUP Sanglah Denpasar
Introduction: Diabetic retinopathy is diabetes mellitus complication which progressively causes microvascular changes in the retina, causing physical and psychosocial impact. According to WHO, diabetic retinopathy ranks fourth in causing blindness with fairly high incidence in Indonesia, namely 42%. There are several risk factors in increasing diabetic retinopathy incidence, one of which is dyslipidemia. Dyslipidemia is disorder body's metabolism of lipid fractions that can be at risk of causing cardiovascular disease. This study aims to determine characteristics dyslipidemia in patients with Diabetic Retinopathy at Sanglah Hospital.
Methods: This research is cross-sectional descriptive study using total sampling technique in taking research samples according inclusion and exclusion criteria. There were five research variables, namely age, sex, body mass index, diabetes duration, and lipid fraction levels.
Results: Diabetic Retinopathy patients with dyslipidemia had prevalence of 76.5% with PDR (64.7%) and mixed dyslipidemia (61.5%) found to be the most dominant. The highest frequency of age, sex, body mass index, and diabetes duration were 45 to 64 years (80.6%), female (92.3%), normoweight (38.5%), more than five years, respectively. years (53.8%).
Conclusion: The prevalence of diabetic retinopathy patients with dyslipidemia in period 2021-2022 is quite high with dominant variable characteristics found in form age 45 to 64 years, female sex, normoweight body mass index, and diabetes duration more than five years.
Pendahuluan: Diabetic retinopathy merupakan suatu komplikasi dari penyakit diabetes melitus yang secara progresif menyebabkan perubahan mikrovaskular di retina sehingga berdampak secara fisik dan psikososial. Menurut WHO, penyakit diabetic retinopathy menempati posisi empat dalam menyebabkan kebutaan dengan kejadian yang cukup tinggi di Indonesia yaitu 42%. Salah satu faktor risiko dalam meningkatkan kejadian penyakit diabetic retinopathy adalah dislipidemia. Dislipidemia merupakan suatu gangguan metabolisme tubuh terhadap fraksi lipid yang bisa berisiko menyebabkan penyakit kardiovaskular. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik dislipidemia pada penderita diabetic retinopathy di RSUP Sanglah.
Metode: Peneltian ini merupakan penelitian deskriptif potong lintang dengan menggunakan teknik total sampling dalam melakukan pengambilan sampel penelitian menyesuaikan kriteria inklusi dan eksklusi. Variabel penelitian berjumlah lima, yaitu umur, jenis kelamin, indeks massa tubuh, durasi diabetes, dan kadar fraksi lipid.
Hasil: Pasien diabetic retinopathy dengan dislipidemia memiliki prevalensi sebesar 76,5% dengan PDR (64,7%) serta dislipidemia campuran (61,5%) ditemukan paling dominan. Frekuensi terbesar pada umur, jenis kelamin, indeks massa tubuh, dan durasi diabetes secara berturut-turut adalah 45 sampai 64 tahun (80,6%), perempuan (92,3%), normoweight (38,5%), lebih dari lima tahun (53,8%).
Simpulan: Prevalensi pasien diabetic retinopathy dengan dislipidemia periode tahun 2021-2022 cukup tinggi dengan karakteristik variabel dominan yang ditemukan berupa umur 45 sampai 64 tahun, jenis kelamin perempuan, indeks massa tubuh normoweight, dan durasi diabetes lebih dari lima tahun.
Hubungan kemampuan berpikir kritis terhadap keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana
Icha Milenia Yanwar, I Gusti Ayu Sri Darmayani, I Gde Haryo Ganesha , I Putu Bayu MayuraOnline First: Jan 10, 2023
- Abstract
Hubungan kemampuan berpikir kritis terhadap keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana
Introduction: Problem-based learning is a method of approach in assisting students in finding problems from a real event. This can affect learning methods to increase skills of critical thinking and active learning, where critical thinking will encourage the formation of knowledge and will be interpreted personally and will be applied to conditions or problems so as to increase active learning. This study aims to determine association between critical thinking skills towards active learning in medical students at Universitas Udayana.
Methods: The respondents of this study were medical students class 2020 in Universitas Udayana. The type of this research is analytic research with a cross-sectional approach. The sampling technique used was the total sampling method and used a questionnaire of critical thinking and active learning.
Results: A total of 165 respondents met the inclusion criteria in this research. The analysis results showed that critical thinking skills increased active learning significantly (p < 0.001) with moderate and direct correlation (r = 0.574).
Conclusion: The ability to think critically can affect the level of active learning in medical education students.
Pendahuluan: Salah satu metode pendekatan untuk membantu mahasiswa dalam menemukan masalah dari suatu peristiwa yang nyata adalah pembelajaran berbasis masalah. Hal ini dapat mempengaruhi metode belajar yang menyebabkan peningkatan kemampuan berpikir dan keaktifan belajar. Berpikir kritis akan mendorong terbentuknya pengetahuan dan akan diinterpretasi personal dan akan diaplikasikan pada kondisi atau masalah sehingga meningkatkan keaktifan belajar. Penelitian ini memiliki tujuan untuk menganalisis hubungan antara kemampuan berpikir kritis dan keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Metode: Responden penelitian ini adalah mahasiswa program studi sarjana kedokteran Universitas Udayana angkatan 2020. Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang. Teknik pengambilan sampel dilakukan dengan total sampling dan menggunakan kuesioner berpikir kritis dan keaktifan belajar.
Hasil: Sebanyak 165 responden memenuhi kriteria inklusi dalam penelitian ini. Hasil analisis menunjukkan bahwa kemampuan berpikir kritis meningkatkan keaktifan belajar secara signifikan (p < 0,001) dengan korelasi sedang dan searah (r = 0,574).
Simpulan: Kemampuan berpikir kritis dapat mempengaruhi tingkat keaktifan belajar pada mahasiswa sarjana kedokteran Universitas Udayana.
Profil klinikopatologi karsinoma prostat di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar periode tahun 2017-2020
Jennifer Louisa, I Wayan Juli Sumadi, Herman Saputra, Ni Putu EkawatiOnline First: Jan 31, 2023
- Abstract
Profil klinikopatologi karsinoma prostat di Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar periode tahun 2017-2020
Background: Prostate cancer or prostate carcinoma is a malignancy that occurs in the cells of the prostate gland and is associated with chronic problems with sexual function, urination, and the patient's psychological well-being. This study was conducted to investigate the clinicopathological profile of prostate cancer patients at Prof dr. I G.N.G. Ngoerah in the period 2017 – 2020.
Methods: This descriptive study used a cross-sectional design conducted at Prof. dr. I G.N.G. Ngoerah Central Hospital. The inclusion criteria were prostate cancer patients in 2017-2020 and the exclusion criteria were patients with incomplete medical record data. The determination of the sample using total sampling with the number of samples that meet the criteria of 82 patients. All statistical analyzes used SPSS ver.25.
Results: Patients in this study had a mean age of 70.89±9.26 years, with the majority aged 50 years and above (97.6%). Most of the patients had the main symptom of urination difficulty (57.5%). PSA levels in patients had a mean of 543.3 ng/mL. Most of the patients had reached stage IV at the time of diagnosis (92.1%). Transurethral resection is the most common specimen retrieval method (47.6%). Almost all samples were diagnosed as acinar adenocarcinoma (95.2%) with the majority categorized into Gleason grade group 5 (64.9%).
Conclusion: Prostate carcinoma cases at Prof. dr. I G.N.G. Ngoerah mostly occurs at the age of >50 years with the main complaint of urination difficulty. The majority of the patients had stage IV with acinar adenocarcinoma histopathological type and Gleason grade group 5.
Latar belakang: Kanker prostat atau karsinoma prostat merupakan keganasan yang terjadi pada sel-sel kelenjar prostat yang berkaitan dengan permasalahan kronis terhadap fungsi seksual, berkemih, serta kesejahteraan psikologis pasien. Penelitian ini dilaksanakan dengan tujuan untuk menyelidiki profil klinikopatologi pasien karsinoma prostat di RSUP Prof dr. I G.N.G. Ngoerah pada periode tahun 2017 – 2020.
Metode: Penelitian ini bersifat deskriptif dengan desain penelitian cross-sectional yang dilakukan di RSUP Prof. dr. I G.N.G. Ngoerah. Kriteria inklusi berupa pasien karsinoma prostat pada tahun 2017-2020 dan kriteria eksklusi berupa pasien dengan data rekam medis yang tidak lengkap. Adapun penentuan sampel menggunakan total sampling dengan jumlah sampel yang memenuhi kriteria sebanyak 82 orang. Seluruh analisis statistik menggunakan SPSS ver.25.
Hasil: Subjek dalam studi ini memiliki mean usia 70,89 ± 9,26 tahun, dengan mayoritas berusia ≥ 50 tahun (97,6%). Sebagian besar pasien mengalami keluhan utama berupa sulit berkemih (57,5%). Kadar PSA pada pasien memiliki mean 543,3 ng/mL. Mayoritas pasien sudah mencapai stadium IV saat terdiagnosis (92,1%). Reseksi transuretral merupakan cara pengambilan sampel dengan frekuensi terbanyak (47,6%). Hampir semua sampel didiagnosis sebagai adenokarsinoma asinar prostat (95,2%) dengan mayoritas Gleason grade group 5 (64,9%).
Simpulan: Kasus karsinoma prostat di RSUP Prof. dr. I G.N.G. Ngoerah sebagian besar terjadi pada usia >50 tahun dengan keluhan utama sulit berkemih. Mayoritas dari pasien menderita stadium IV dengan tipe histopatologi adenokarsinoma asinar dan Gleason grade group 5.
Komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah di RSUD Wangaya Kota Denpasar
Ancelia Limantara, Wayan Bikin Suryawan, Anak Agung Made Sucipta, Han's ChristianOnline First: Jan 10, 2023
- Abstract
Komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah di RSUD Wangaya Kota Denpasar
Background: A bilirubin level in the blood higher than normal is called hyperbilirubinemia. Hyperbilirubinemia's prevalence is 60% in term newborns and 80% in preterm newborns. Low birth weight is a risk factor for hyperbilirubinemia. Phototherapy for low birth weight with hyperbilirubinemia is given for a longer time and has a higher rebound effect. This study aims to compare phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth weight.
Methods: Analytical study using medical records at Wangaya Hospital during January 2020-January 2022. Inclusion criteria include hyperbilirubinemia required phototherapy, bilirubin level before and after phototherapy checked, and single light phototherapy. Exclusion criteria include conjugated hyperbilirubinemia, exchange transfusion, sepsis, severe congenital malformation, patients in NICU and incomplete medical record.
Results: From 99 study subjects, 19% had low birth weight, and 81% had normal birth weight. The mean bilirubin serum before phototherapy was 15.52mg/dL for LBW and 15.27mg/dL for NBW. The mean bilirubin serum after phototherapy was 5.77mg/dL for LBW and 7.46mg/dL for NBW. The mean bilirubin difference was 9.75mg/dL for LBW and 7.81mg/dL for NBW. The mean phototherapy duration was 52 hours for LBW and 47.6 hours for NBW. Decreasing rate of bilirubin was 0.19mg/dL/hour for LBW and 0.18mg/dL/hour for NBW. Independent t-test showed a p-value of 0.571, meaning no significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between normal birth weight and low birth.
Conclusion: No significant difference was found in phototherapy effectiveness in treating hyperbilirubinemia between NBW and LBW. But, phototherapy in LBW was started earlier, required more time and has a lower bilirubin level target than NBW.
Latar Belakang: Bilirubin darah melebihi normal disebut hiperbilirubinemia. Prevalensi hiperbilirubinemia berkisar antara 60% pada bayi cukup bulan dan 80% pada bayi prematur. Bayi berat lahir rendah merupakan risiko hiperbilirubinemia. Fototerapi bayi berat lahir rendah diberikan lebih lama daripada bayi berat lahir normal dan memiliki efek rebound lebih tinggi. Tujuan penelitian adalah mengetahui komparasi efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Metode: Penelitian analitik menggunakan rekam medis di RSUD Wangaya Kota Denpasar periode Januari 2020-Januari 2022. Kriteria inklusi pada penelitian ini adalah pasien hyperbilirubinemia yang memerlukan fototerapi, kadar bilirubin sebelum dan sesudah fototerapi, dan fototerapi single-light. Kriteria eksklusi meliputi hiperbilirubinemia terkonjugasi, transfusi tukar, sepsis, kelainan kongenital berat, pasien perawatan di NICU, serta rekam medis tidak lengkap.
Hasil: Dari 99 subyek penelitian, 19% BBLR dan 81% BBLN. Rerata bilirubin pre-fototerapi 15,52 mg/dL pada BBLR dan 15,27 mg/dL pada BBLN. Rerata bilirubin post fototerapi 5,77mg/dL pada BBLR dan 7.46 mg/dL pada BBLN. Rerata selisih bilirubin fototerapi 9,75 mg/dL pada BBLR dan 7,81 mg/dL pada BBLN. Rerata waktu fototerapi 52 jam pada BBLR dan 47,6 jam pada BBLN. Laju turun bilirubin 0,19 mg/dL/jam pada BBLR dan 0,18 mg/dL/jam pada BBLN. Uji t-test tidak berpasangan menunjukkan p-value > 0,05 yaitu 0,571 menandakan tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah.
Kesimpulan: Tidak ada perbedaan efektifitas fototerapi dalam kasus hiperbilirubinemia pada kelompok bayi berat lahir normal dan rendah. Namun, didapatkan bahwa fototerapi dimulai pada usia yang lebih awal, dengan waktu fototerapi yang lebih lama dan target bilirubin pasca fototerapi yang lebih rendah pada kelompok BBLR dibandingkan BBLN.
Karakteristik audiometri pada pasien dengan otitis media supuratif kronis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari 2018–Desember 2019
Gede Kurnia Mayura, I Made WiranadhaOnline First: Feb 15, 2023
- Abstract
Karakteristik audiometri pada pasien dengan otitis media supuratif kronis di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode Januari 2018–Desember 2019
Background: Chronic suppurative otitis media (CSOM) is one of the causes of ear disorders in various countries, especially developing countries. The prevalence of CSOM in Indonesia is 3.8% or an estimated 6.6 million Indonesian population. The purpose of this study was to determine the audiometric characteristics of CSOM patients at the ENT Polyclinic, Prof. Dr. I.G.N.G. Ngoerah Hospital in the period of 2018-2019.
Methods: This research used a retrospective descriptive study design. Sampling was carried out by total sampling, namely every patient who met the research inclusion criteria was included in the research sample. The number of samples used are all descriptive data collected on a predetermined period scale in the research design where the study obtained 70 research samples.
Results: There were 33 (47.14%) female and 37 (52.86%) male with CSOM. There were 4 people (5.71%) of CSOM aged ≤ 10 years, 10 (14.29%) aged 11-20 years, 8 (11.43%) aged 21-30 years, 9 (12.86%) aged 31-40 years, 19 (27.14%) aged 41-50 years, 11 (15.71%) aged 51-60 years, 5 (7.14%) aged 61-70 years, 4 (5.71%) aged more than 70 years. Furthermore, 42 people (60%) with CSOM had conductive hearing loss (CHL). 12.86% of patients had sensorineural hearing loss (SNHL), 13 people with CSOM had mild deafness (22.86%), 13 people had moderate deafness (34.29%), 24 people had moderate-severe deafness (28.57%), 20 people had severe deafness (28.6%), 8 people had very severe deafness (11.46%).
Conclusion: The proportion of CSOM patients in the ENT polyclinic at RSUP Prof. Dr. I.G.N.G. Ngoerah from 2018 to 2019, there were more males than females and the highest distribution of CSOM was in the age range of 41-50 years. Conductive deafness is the highest type of hearing loss and judging from the degree of deafness, most people with CSOM have moderate to severe deafness.
Latar Belakang: Otitis media supuratif kronis (OMSK) merupakan salah satu penyebab gangguan telinga di berbagai negara, terutama negara berkembang. Prevalensi OMSK di Indonesia adalah 3,8% atau diperkirakan sekitar 6,6 juta penduduk Indonesia. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik audiometri pada penderita OMSK di Poliklinik THT-KL RSUP Prof. Dr. I.G.N.G. Ngoerah periode 2018-2019.
Metode: Penelitian ini menggunakan rancangan penelitian deskriptif retrospektif. Pengambilan sampel dilakukan secara total sampling yaitu setiap penderita yang memenuhi kriteria inklusi penelitian dimasukkan dalam sampel penelitian. Jumlah sampel yang dipergunakan adalah semua data deskriptif yang terkumpul pada skala periode yang telah ditentukan pada rancangan penelitian dimana pada penelitian didapatkan 70 sampel penelitian.
Hasil: Penderita OMSK perempuan sebanyak 33 orang (47,14%) dan penderita OMSK laki-laki sebanyak 37 orang (52,86%). Terdapat 4 orang (5,71%) OMSK berusia ≤ 10 tahun, 10 (14,29%) berusia 11-20 tahun, 8 (11,43%) berusia 21-30 tahun, 9 (12,86%) berusia 31-40 tahun, 19 (27,14%) berusia 41-50 tahun, 11 (15,71%) berusia 51-60 tahun, 5 (7,14%) berusia 61-70 tahun, 4 (5,71%) berusia lebih dari 70 tahun. Lebih lanjut, 42 pasien (60%) dengan OMSK mengalami gangguan pendengaran konduktif. 12,86% pasien mengalami gangguan pendengaran sensorineural, OMSK dengan tuli ringan sebanyak 13 orang (22,86%), tuli sedang 13 orang (34,29%), tuli sedang-berat 24 orang (28,57%), tuli berat 20 orang, tuli berat (28,6%), tuli sangat berat 8 orang (11,46%).
Simpulan: Proporsi penderita OMSK di poliklinik THT KL RSUP Prof. Dr. I.G.N.G. Ngoerah dari tahun 2018 sampai dengan tahun 2019, laki-laki lebih besar dari pada penderita perempuan dan distribusi OMSK tertinggi pada rentang usia 41-50 tahun. Tuli konduktif merupakan tipe gangguan pendengaran yang paling tinggi dan dilihat dari derajat ketuliannya, penderita OMSK sebagian besar memiliki derajat ketulian sedang-berat.
Hubungan tingkat aktivitas fisik dengan andropause pada guru sekolah menengah atas di Kota Denpasar tahun 2022
Anak Agung Bagus Putra Indrakusuma, Yukhi Kurniawan, I Gusti Ngurah Pramesemara, I Nyoman Mangku KarmayaOnline First: Jan 10, 2023
- Abstract
Hubungan tingkat aktivitas fisik dengan andropause pada guru sekolah menengah atas di Kota Denpasar tahun 2022
Introduction: Andropause is clinical syndrome due to testosterone levels reduction below normal in the body experienced by elderly men. The level of physical activity is one of the risk factors for andropause. This study aims to determine the relationship between the level of physical activity and andropause in high school teachers in Denpasar City.
Methods: This study is an observational analysis with a cross-sectional approach. Andropause was assessed using the ADAM questionnaire consisting of 10 questions. Meanwhile, the level of physical activity assessed using the GPAQ questionnaire consisting of 16 questions. The sampling technique used is purposive sampling.
Results: Total 50 respondents include in this study. As many as 66% of respondents have low levels of physical activity, 26% moderate physical activity, and 4% high physical activity. A total of 32 (64.0%) respondents experienced andropause and 18 (36.0%) did not experience andropause. There was a significant association between low levels of physical activity and andropause (p=0,05). The odds ratio (OR 95%CI) between andropause with low levels of physical activity is 11,14 (1,0 – 124,33).
Conclusion: The lower level of physical activity teachers at Denpasar City Senior High School, the higher risk of experiencing andropause. This research is expected to motivate and educate men to be more aware of andropause and keep physically active.
Pendahuluan: Andropause adalah sindrom klinis akibat penurunan kadar testosteron di bawah normal dalam tubuh yang dialami oleh pria lanjut usia. Tingkat aktivitas fisik menjadi salah satu faktor risiko terhadap andropause. Penelitian ini bertujuan untuk mengetahui hubungan tingkat aktivitas fisik dengan andropause pada guru SMA di Kota Denpasar.
Metode: Penelitian ini merupakan analisis observasional dengan pendekatan cross-sectional. Andropause dinilai menggunakan kuesioner ADAM yang terdiri dari 10 buah pertanyaan. Sementara itu, tingkat aktivitas fisik dinilai menggunakan kuesioner GPAQ yang terdiri dari 16 buah pertanyaan. Teknik pengambilan sampel yang digunakan adalah purposive sampling.
Hasil: Responden dalam penelitian ini berjumlah 50 orang. Sebanyak 66% responden memiliki tingkat aktivtas fisik yang rendah, 26% aktivitas fisik sedang, dan 4% aktivitas fisik tinggi. Sebanyak 32 (64,0%) responden mengalami andropause dan 18 (36,0%) tidak mengalami andropause. Terdapat hubungan yang signifikan antara tingkat aktivitas fisik rendah dengan andropause (p = 0,05). Adapun nilai odd ratio (OR 95%CI) antara andropause dengan tingkat aktivitas fisik rendah adalah 11,14 (1,0 – 124,33).
Simpulan: Semakin rendah tingkat aktivitas fisik guru di SMA Kota Denpasar, maka semakin tinggi risiko mengalami andropause. Penelitian ini diharapkan dapat memotivasi dan mengedukasi pria untuk lebih waspada terhadap andropause serta menjaga fisiknya tetap aktif.
Prevalensi dan faktor risiko penyakit jantung koroner pada pasien diabetes melitus tipe 2 Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar
Richard Timothy Elkurnia, Cokorde Istri Yuliandari Krisnawardani K, Luh Oliva Saraswati Suastika, Cyndiana Widia Dewi SinardjaOnline First: Jan 10, 2023
- Abstract
Prevalensi dan faktor risiko penyakit jantung koroner pada pasien diabetes melitus tipe 2 Rumah Sakit Umum Pusat Prof. Dr. I.G.N.G. Ngoerah Denpasar
Background: Coronary heart disease (CHD) is a complication of type 2 diabetes mellitus (DMT2). However, in the process of developing CHD in T2DM patients, other risk factors that contribute multifactorial are needed. This study aims to determine the prevalence of CHD events in T2DM patients as well as to determine the relationship between risk factors and CHD events in T2DM patients.
Methods: This study is an analytic cross-sectional study conducted at Prof. Dr. I.G.N.G. Ngoerah Hospital. The population target was all T2DM patients in the period January 2021-December 2021, in which 80 patient samples were obtained according to the inclusion and exclusion criteria and were taken through secondary data on patient medical records. Data processing was carried out using the SPSS ver. 28.0.1.1.
Results: The prevalence of CHD in T2DM patients was 25 people (31.3%). The risk factors for CHD in T2DM patients are hyperglycemia (HbA1c ≥6.5%) (p=0.036, 95% CI=1.166-85.788, aOR=10.567), blood pressure ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), and obesity (p=0.014, 95%CI=1.364-16.420, aOR=4.732) while male sex (p=0.428), age ≥50 years (p=0.543), smoking (p=0.937), family history of cardiovascular disease (p=0.663), LDL ≥160 mg/dL (p=0.946), triglyceride ≥200 mg/dL (p=0.192, 95%CI=0.680-6.847, aOR=2.158), HDL <40 mg/dL (p=0.487), and total cholesterol level ≥240 mg/dL (p=0.866) are not significantly associated with CHD events in patients DMT2.
Conclusion: The prevalence of CHD in T2DM patients is 31.1% at Prof. Dr. I.G.N.G. Ngoerah Hospital in 2021. Risk factors such as hyperglycemia, blood pressure ≥140/90 mmHg, and obesity are significantly associated with the incidence of CHD in T2DM patients.
Latar belakang: Penyakit jantung koroner (PJK) merupakan salah satu komplikasi diabetes melitus tipe 2 (DMT2). Namun, dalam proses perkembangan PJK pada pasien DMT2, diperlukan faktor risiko lainnya yang berkontribusi secara multifactorial. Secara teoritis, jenis kelamin laki-laki, usia, riwayat merokok, riwayat penyakit kardiovaskuler keluarga, hiperglisemia, dislipidemia, tekanan darah ≥140/90mmHg, dan obesitas merupakan faktor risiko PJK pada DMT2. Penelitian ini bertujuan untuk mengetahui prevalensi kejadian PJK pada pasien DMT2 sekaligus untuk mengetahui hubungan faktor risiko dengan kejadian PJK pada pasien DMT2.
Metode: Penelitian ini merupakan penelitian cross-sectional analitik yang dilakukan pada RSUP Prof. Dr. I.G.N.G. Ngoerah dengan target penelitian adalah seluruh pasien DMT2 pada periode Januari 2021-Desember 2021. Pada penelitian ini, 80 sampel pasien yang sesuai dengan kriteria inklusi dan eksklusi diambil melalui data sekunder rekam medis pasien. Pengolahan data dilakukan menggunakan aplikasi SPSS ver. 28.0.1.1.
Hasil: Prevalensi PJK pada pasien DMT2 adalah sebanyak 25 orang (31.3%). Adapun faktor risiko PJK pada pasien DMT2 adalah Hiperglisemia (HbA1c ≥6.5%) (p=0.036, 95%CI=1.166-85,788, aOR=10.567), tekanan darah ≥140/90 mmHg p=0.008, 95%CI=11.541-17.017, aOR=5.121), dan obesitas (p=0.014, 95%CI=1.364-16.420, aOR=4.732) sedangkan jenis kelamin laki-laki (p=0.428), usia ≥50 tahun (p=0.543), riwayat merokok (p=0.937), riwayat penyakit kardiovaskuler keluarga (p=0.663), kadar LDL ≥160 mg/dL (p=0.946), kadar trigliserida ≥200 mg/dL(p=0.192, CI=0.680-6.847, aOR=2.158), kadar HDL <40 mg/dL (p=0.487), kadar total kolesterol ≥240 mg/dL (p=0.866) tidak berhubungan secara signifikan dengan kejadian PJK pada pasien DMT2.
Simpulan: Prevalensi PJK pada pasien DMT2 sebesar 31.1%. Faktor risiko berupa hiperglisemia, tekanan darah ≥140/90 mmHg, dan obesitas berhubungan signifikan dengan kejadian PJK pada pasien DMT2.
Hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung tahun 2022
Anak Agung Ayu Ratih Andira Putri, Yukhi Kurniawan, I Gusti Ngurah Pramesemara, I Nyoman Mangku KarmayaOnline First: Jan 11, 2023
- Abstract
Hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung tahun 2022
Introduction: Andropause is a collection of clinical symptoms due to a decrease in testosterone levels below normal limits. Androgenic alopecia is baldness caused by the susceptibility of the follicles to androgen hormones. The aims of study is determining the relationship between androgenic alopecia and andropause in civil servants at the Badung Regency Government Center.
Methods: The study design is cross-sectional with descriptive analytic. ADAM questionnaire is used to assessed andropause. Meanwhile, Norwood-Hamilton baldness scale is used to assessed androgenic alopecia.
Results: Respondents in this study amounted to 40 people. A total of 27 (67.5%) positive andropause respondents and 13 respondents (33.5%) negative andropause. Meanwhile, 21 respondents (52.1%) were positive for androgenic alopecia and 19 respondents (47.5%) were negative for androgenic alopecia. There was a significant relationship (p<0.001) between andropause and androgenic alopecia. The odd ratio value (OR 95%CI) between andropause and androgenic alopecia is 34.3 (3.726-313.837).
Conclusion: Andropause has a significant relationship to androgenic alopecia of civil servants at the Badung Regency Government Center.
Pendahuluan: Andropause adalah kumpulan gejala klinis akibat kadar testosteron yang menurun di bawah batas normal. Alopesia androgenik adalah kebotakan yang disebabkan kerentanan folikel terhadap hormon androgen. Tujuan penelitian adalah menganalisis hubungan andropause dengan alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.
Metode: Rancangan penelitian adalah cross-sectional dengan deskriptif analitik. Kuesioner ADAM digunakan untuk menilai andropause dinilai. Sedangkan, alopesia androgenik dinilai dengan menggunakan skala kebotakan Norwood-Hamilton.
Hasil: Responden dalam penelitian ini berjumlah 40 orang. Sebanyak 27 (67,5%) responden positif andropause dan 13 responden (33,5%) negatif andropause. Sementara itu, 21 responden (52,1%) positif alopesia androgenik dan 19 responden (47,5%) negatif alopesia androgenik. Terdapat hubungan yang signifikan (p<0,001) antara andropause dan alopesia androgenik. Adapun nilai odd ratio (OR 95%CI) antara andropause dan alopesia androgenik adalah 34,3 (3,726-313,837).
Simpulan: Andropause memiliki hubungan signifikan terhadap alopesia androgenik pada aparatur sipil negara di Pusat Pemerintahan Kabupaten Badung.
